van Velsen Valery, van Helmond Noud, Chapman Kenneth B
Radboud University Medical Center, Nijmegen, the Netherlands.
Spine & Pain Institute of New York, New York City, New York, U.S.A.
Pain Pract. 2018 Apr;18(4):539-543. doi: 10.1111/papr.12638. Epub 2017 Dec 6.
Chronic neuropathic pain is often refractory to conventional medical treatments and leads to significant disability and socio-economic burden. Dorsal root ganglion (DRG) stimulation has recently emerged as a treatment for persistent neuropathic pain, but creating a strain relief loop at the S1 level has thus far been a challenging technical component of DRG lead placement. We describe a refined technique for strain relief loop formation at the S1 level using a transforaminal approach that we employed in a 45-year-old patient with intractable foot pain. We successfully placed a strain relief loop in the sacral space in a predictable and easily reproducible manner using a transforaminal anchorless approach. The patient experienced a decrease in visual analog pain score (85%), and improvement in function during the trial period, and proceeded with permanent implantation. The described sacral transforaminal strain relief loop formation technique appears to be a more reliable and predictable technique of DRG lead placement in the sacrum than those previously documented.
慢性神经性疼痛通常对传统医学治疗无效，并导致严重残疾和社会经济负担。背根神经节（DRG）刺激最近已成为治疗持续性神经性疼痛的一种方法，但在S1水平创建一个应力消除环迄今为止一直是DRG导联放置中具有挑战性的技术环节。我们描述了一种使用经椎间孔方法在S1水平形成应力消除环的改进技术，我们在一名患有顽固性足部疼痛的45岁患者中采用了该方法。我们使用经椎间孔无锚定方法以可预测且易于重复的方式成功地在骶骨空间放置了一个应力消除环。患者在试验期间视觉模拟疼痛评分降低（85%），功能得到改善，并进行了永久植入。所描述的骶骨经椎间孔应力消除环形成技术似乎比先前记录的技术在骶骨中进行DRG导联放置时更可靠且可预测。
