An Anatomy-Informed, Novel Technique for S1 Dorsal Root Ganglion Stimulation Lead Placement
Kenneth B. Chapman, Noud van Helmond, Jan Willem Kallewaard, Kris Vissers, Kiran V. Patel, Soriaya Motivala, Jonathan M. Hagedorn, Timothy R. Deer, David Dickerson
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.