Neurosurgical Associates of Lancaster, Lancaster, PA, USA.
St. Luke's School of Medicine, Bethlehem, PA, USA.
Neuromodulation. 2020 Feb;23(2):252-257. doi: 10.1111/ner.13039. Epub 2019 Sep 2.
Dorsal root ganglion (DRG) stimulation has been established as a therapy in the treatment of chronic pain. Ideal electrode placement is guided by proper identification of the location of the DRG. The location of the S1 DRG is not well delineated and can be variable making ideal location of the electrode placement difficult based on fluoroscopic imaging.
This is a retrospective analysis of postoperative programming of S1 DRG leading across two centers. There were 34 lead placements in 24 patients included in this study. Programming parameters and contacts used were evaluated based on the position of the electrode in reference to the sacral border.
The majority of the patient programming parameters were recorded at six weeks following the implant. Most commonly, the programming used a simple continuous bipole configuration. Of the 34 leads programmed, 17 (50%) had programming on the sacral border, 14 (41%) were considered posterior, and 3 (9%) were anterior to the sacral border.
This analysis of S1 DRG programming demonstrates that ideal positioning of the majority of the contacts for the electrode should be posterior and along the sacral border on fluoroscopic imaging. These findings also suggest that the S1 DRG may be located most reproducibly at the border of the intraforaminal and intracanalicular region.
背根神经节（DRG）刺激已被确立为治疗慢性疼痛的一种疗法。理想的电极放置是通过正确识别 DRG 的位置来指导的。S1 DRG 的位置没有很好地划定，并且可能会发生变化，因此根据荧光透视成像，很难确定电极放置的理想位置。
这是对两个中心的 S1 DRG 术后编程的回顾性分析。本研究共纳入 24 例患者的 34 个导联。根据电极相对于骶骨边界的位置评估编程参数和使用的触点。
大多数患者的编程参数是在植入后六周记录的。最常用的编程方法是简单的连续双极配置。在编程的 34 个导联中，17 个（50%）位于骶骨边界上，14 个（41%）位于骶骨后，3 个（9%）位于骶骨前。
这项对 S1 DRG 编程的分析表明，对于大多数电极触点，理想的定位应位于骶骨边界上，并在荧光透视成像上位于骶骨后。这些发现还表明，S1 DRG 可能最可重复地位于椎间孔和管内区域的边界处。
