• P J Slotty, G Bara, and J Vesper.
• Department of Stereotactic and Functional Neurosurgery, Neurosurgical Clinic, Heinrich-Heine University, Düsseldorf, Germany, slotty@hhu.de.
• Acta Neurochir (Wien). 2015 Jan 1;157(1):105-8.

BackgroundOccipital nerve stimulation is increasingly used in the treatment of primary headache disorders. We describe a surgical technique applying preoperative fluoroscopy and intraoperative tactile orientation designed to reduce radiation exposure and provide reproducible results.MethodUnder general anesthesia and in the supine position, the C1-C2 transition is identified fluoroscopically and marked with an electrocardiogram (ECG) electrode prior to surgery. During electrode placement, the ECG electrodes are used for tactile orientation of electrode direction and depth.ConclusionsThe use of tactile orientation solely during surgery reduces radiation exposure and decreases the duration of surgery. This technique allows reproducible results of final electrode position.

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