• Carlos Velásquez, Kantharuby Tambirajoo, Paulo Franceschini, Paul R Eldridge, and Jibril Osman Farah.
• Department of Neurological Surgery and Spine Unit, Hospital Universitario Marqués de Valdecilla and Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain. Electronic address: carvelhn@gmail.com.
• World Neurosurg. 2018 Jun 1; 114: e641-e646.

ObjectiveTo describe the indications and outcomes of upper cervical cord stimulation in trigeminal neuropathy.MethodsA consecutive single-center series of patients was retrospectively reviewed. It included 12 patients with trigeminal neuropathy treated with upper cervical spinal cord stimulation. Clinical features, complications, and outcomes were reviewed.ResultsAll patients had a successful trial before the definitive implantation of a spinal cord stimulator at the level of the craniocervical junction. The mean follow-up period was 4.4 years (range, 0.3-21.1 years). The average coverage in the pain zone was 72% and the median baseline, trial, and postoperative numeric rating scale (NRS) was 7, 3, and 3, respectively. When compared with the baseline, the mean reduction achieved in the postoperative average numeric rating scale was 4 points, accounting for a 57.1% pain reduction. The long-term failure rate was 25%.ConclusionsDespite there being enough evidence to consider upper cervical spinal cord stimulation as an effective treatment for patients with neuropathic trigeminal pain, a randomized controlled trial is needed to fully assess its indications and outcomes and compare it with other therapeutic approaches.Copyright © 2018 Elsevier Inc. All rights reserved.

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