scholarly journals Sciatic, Femoral, and Lateral Femoral Cutaneous Nerve Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation

Pain Medicine ◽  
2020 ◽  
Vol 21 (Supplement_1) ◽  
pp. S47-S50
Author(s):  
Harmandeep Singh ◽  
Akshat Gargya ◽  
Tiffany Lin ◽  
Amitabh Gulati

Abstract Objective With advances in peripheral nerve stimulation technology, there has been an emergence of new minimally invasive techniques to provide neurostimulation therapies for chronic pain. This technical note describes the utilization of ultrasonography for percutaneous placement of peripheral nerve stimulation leads at the sciatic, femoral, and lateral femoral cutaneous nerves. Methods Ultrasound can be utilized to localize a specific nerve, view neighboring soft tissue anatomy, and plan a needle trajectory. Various ultrasound techniques and transducer orientations allow for multiple options for lead placement relative to the targeted nerve. Conclusions The option of ultrasound-guided percutaneous technique for neurostimulation lead placement allows this treatment modality to be made available to more patients with chronic pain in specific nerve distributions.

Pain Medicine ◽  
2020 ◽  
Vol 21 (Supplement_1) ◽  
pp. S38-S40
Author(s):  
Akshat Gargya ◽  
Harmandeep Singh ◽  
Tiffany Lin ◽  
Amitabh Gulati

Abstract Objective Peripheral nerve stimulation provides targeted stimulation and pain relief within a specific nerve distribution. This technical case report provides a method to perform selective nerve root stimulation of thoracic and lumbar spinal nerves using ultrasonography. Methods Ultrasound-guided peripheral nerve stimulation of thoracic and lumbar spinal nerves allows better visualization of soft tissue anatomy and planning of needle trajectory. Conclusions Ultrasound-guided peripheral nerve stimulation procedures may provide a safer method for neurostimulation lead placement when compared with fluoroscopic-guided techniques.


Pain Medicine ◽  
2020 ◽  
Vol 21 (Supplement_1) ◽  
pp. S6-S12 ◽  
Author(s):  
Tiffany Lin ◽  
Akshat Gargya ◽  
Harmandeep Singh ◽  
Eellan Sivanesan ◽  
Amitabh Gulati

Abstract Introduction With the advancement of technology, peripheral nerve stimulation (PNS) has been increasingly used to treat various chronic pain conditions. Its origin is based on the gate control theory postulated by Wall and Melzack in 1965. However, the exact mechanism behind PNS’ analgesic effect is largely unknown. In this article, we performed a comprehensive literature review to overview the PNS mechanism of action. Design A comprehensive literature review on the mechanism of PNS in chronic pain. Methods Comprehensive review of the available literature on the mechanism of PNS in chronic pain. Data were derived from database searches of PubMed, Scopus, and the Cochrane Library and manual searches of bibliographies and known primary or review articles. Results Animal, human, and imaging studies have demonstrated the peripheral and central analgesic mechanisms of PNS by modulating the inflammatory pathways, the autonomic nervous system, the endogenous pain inhibition pathways, and involvement of the cortical and subcortical areas. Conclusions Peripheral nerve stimulation exhibits its neuromodulatory effect both peripherally and centrally. Further understanding of the mechanism of PNS can help guide stimulation approaches and parameters to optimize the use of PNS.


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