Division of Urogynecology, Department of Obstetrics and Gynecology, Duke University Medical Center, 5324 McFarland Drive, Unit 310, Durham, NC, 27707, USA.
Int Urogynecol J. 2021 Sep;32(9):2545-2547. doi: 10.1007/s00192-020-04615-8. Epub 2020 Nov 25.
To develop an instructional video that correlates cadaveric anatomy with fluoroscopic images to assist in conceptualization of optimal placement of the foramen needle and lead to complete an efficient and successful sacral neuromodulation (SNM) procedure.
A SNM procedure was performed and recorded on a fresh female cadaver. Fluoroscopic images were obtained during the procedure to highlight the bony relationships to the S3 foramen and nerve. Dissection of the anterior and posterior sacrum was completed to highlight the tract of the S3 nerve. Techniques to increase the likelihood of optimal foramen needle and thus lead placement were highlighted.
This video demonstrates how achieving optimal foramen needle placement within the S3 foramen is key to optimal lead placement. Understanding the relationship of the bony landmarks on fluoroscopy to the S3 nerve and foramen, seen in the cadaveric dissections, are important in understanding how to achieve optimal lead placement. This optimization should lead to decreased operating room time, maximization of programming options, and decreased amplitude requirements.
制作一段教学视频，将尸体解剖与透视图像相关联，以帮助理解最佳的椎间孔针放置位置，并实现高效、成功的骶神经调节（SNM）手术。
对一具新鲜的女性尸体进行 SNM 手术，并进行记录。在手术过程中获取透视图像，以突出 S3 椎间孔和神经的骨骼关系。完成了对前、后骶骨的解剖，以突出 S3 神经的轨迹。强调了增加最佳椎间孔针和引导线放置可能性的技术。
本视频演示了如何实现 S3 椎间孔内的最佳椎间孔针放置，这是实现最佳引导线放置的关键。了解透视图像上的骨性标志与 S3 神经和椎间孔的关系，以及在尸体解剖中看到的关系，对于理解如何实现最佳的引导线放置非常重要。这种优化应该会减少手术室时间、最大化编程选项和降低幅度要求。
