Ultrasound Guidance for the Placement of Peripheral Nerve Stimulation Devices

Author(s):  
Mayank Gupta ◽  
Timothy R. Deer
2021 ◽  
Vol 11 (2) ◽  
Author(s):  
Ezio Amorizzo ◽  
Gianni Colini-Baldeschi

Introduction: Neuropathic pain can be caused by several pathologies affecting the nervous system. Peripheral neuralgias may be related to nerve entrapment, traumatic or iatrogenic events, and may also accompany many other diseases. Peripheral nerve stimulation is effective in treating many of these neuralgic syndromes. Case Presentation: We treated two patients suffering from chronic neuropathic pain of peripheral origin with the implantation of a Bioness (Valencia CA, USA) StimRouter® peripheral nerve stimulation system with follow-up visits at 1 - 3 - 6 - 12 months. Conclusions: PNS performed with the StimRouter® system, implanted percutaneously under ultrasound guidance, is safe and effective for patients.


Pain Medicine ◽  
2020 ◽  
Vol 21 (Supplement_1) ◽  
pp. S51-S55
Author(s):  
Nicholas S Gregory ◽  
Abdullah S Terkawi ◽  
Nitin K Prabhakar ◽  
Johnathan V Tran ◽  
Vafi Salmasi ◽  
...  

Abstract Background Pudendal neuropathy is a chronic, disabling form of perineal pain that involves the pudendal nerve, a mixed somatic and autonomic nerve that originates from sacral nerve roots. Peripheral nerve stimulation of the pudendal nerve can be useful to decrease symptom burden in patients who have failed initial conservative treatment modalities. Methods In this manuscript, we describe an approach to the placement of a peripheral nerve stimulator for the treatment of pudendal neuralgia. We present a case of complex pelvic neuropathy and review the factors that lead to successful placement. Technical aspects of stimulator placement and ultrasound landmarks are reviewed. Results A lateral to medial approach with ultrasound guidance at the level of the ischial spine is likely to facilitate proper lead placement along the course of the pudendal nerve. Aftercare and adherence to postimplant activity restrictions–particularly avoiding use of the extremes of hip flexion and extension for four weeks—lead to the absence of lead migration. Conclusions Pudendal nerve stimulation is an emerging technique for neuromodulation of refractory pudendal neuralgia. Ultrasound-guided pudendal nerve stimulation is a viable technique for neuromodulation of pudendal neuralgia. Optimization of patient selection, ultrasound guidance, and proper adherence to postimplant activity restrictions may be helpful for long-term therapeutic success.


2021 ◽  
pp. 2004033
Author(s):  
Estelle A. Cuttaz ◽  
Christopher A. R. Chapman ◽  
Omaer Syed ◽  
Josef A. Goding ◽  
Rylie A. Green

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