An Anatomy-Informed, Novel Technique for S1 Dorsal Root Ganglion Stimulation Lead Placement.

IF 3 4区医学 Q2 TOXICOLOGY Forensic Toxicology Pub Date : 2022-09-30 DOI:10.1093/pm/pnac062

Kenneth B Chapman, Noud van Helmond, Jan Willem Kallewaard, Kris C Vissers, Kiran V Patel, Soriaya Motivala, Jonathan M Hagedorn, Timothy R Deer, David M Dickerson

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Abstract

Objective: A heightened and organized understanding of sacral anatomy could potentially lead to a more effective and safe method of dorsal root ganglion stimulation (DRG-S) lead placement. The aim of this technical note is to describe a standardized access method for S1 DRG-S lead placement.

Design: Technical note.

Methods: The described approach utilizes alignment of the lumbosacral prominence and is measurement-based, allowing for standardized sacral access, even when visualization is suboptimal. The medial-to-lateral needle trajectory is designed to limit interaction with the sensitive neural structures and allows for a more parallel orientation of the lead to the DRG and nerve root.

Conclusions: The described technique potentially improves the safety of S1 DRG-S lead placement. The parallel lead orientation to the DRG may also increase efficacy while lowering energy requirements.

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一种以解剖学为依据的 S1 背根神经节刺激导线放置新技术。

目的：加深对骶骨解剖的理解并使之条理化，有可能为背根神经节刺激（DRG-S）导联置入提供更有效、更安全的方法。本技术说明旨在描述 S1 DRG-S 导联置入的标准化入路方法：设计：技术说明：所描述的方法利用腰骶部突出部位的对齐，并以测量为基础，即使在可视性不佳的情况下也能实现标准化的骶骨入路。从内侧到外侧的进针轨迹旨在限制与敏感神经结构的相互作用，并使导线与 DRG 和神经根的方向更加平行：结论：所述技术可提高 S1 DRG-S 导联置入的安全性。与 DRG 平行的导联方向还可提高疗效，同时降低能量需求。

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来源期刊

Forensic Toxicology TOXICOLOGY-

CiteScore

5.80

自引率

9.10%

发文量

审稿时长

3 months

期刊介绍： The journal Forensic Toxicology provides an international forum for publication of studies on toxic substances, drugs of abuse, doping agents, chemical warfare agents, and their metabolisms and analyses, which are related to laws and ethics. It includes original articles, reviews, mini-reviews, short communications, and case reports. Although a major focus of the journal is on the development or improvement of analytical methods for the above-mentioned chemicals in human matrices, appropriate studies with animal experiments are also published. Forensic Toxicology is the official publication of the Japanese Association of Forensic Toxicology (JAFT) and is the continuation of the Japanese Journal of Forensic Toxicology (ISSN 0915-9606).