Implanted occipital nerve stimulators
Abstract
BACKGROUND: Chronic headache represents a very significant public health and economic issue. One treatment modality for chronic refractory headache involves the use of subcutaneous implanted neurostimulator leads in the occipital region. Varied types of headache etiologies including migraine, transformed migraine, chronic daily headache, cluster headache, hemicrania continua, occipital neuralgia, and cervicogenic headache have been studied with peripheral nerve field stimulation and found responsive to stimulation of the suboccipital region, known commonly as occipital nerve stimulation (ONS).
OBJECTIVE: To evaluate the strength of evidence that occipital nerve stimulation is an effective treatment of benign headache.
STUDY DESIGN: A systematic review of occipital nerve stimulation for the treatment of chronic headache.
METHODS: A systematic review of the literature through EMBASE and PubMed/Medline for clinical studies was performed. The Agency for Healthcare Research and Quality (AHRQ) criteria was utilized to assess the evidence regarding occipital nerve stimulators and arrives at conclusions as to their efficacy in the treatment of headache. Studies were also graded using AHRQ criteria. The overall body of evidence was then graded on a 5 level scale from Level I (conclusive), Level II (strong), Level III (moderate), Level IV (limited) to Level V (indeterminate).
RESULTS: Ten observational studies, of which 4 were prospective, and a number of case series, case reports,…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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