Sampogna Gianluca, Montanari Emanuele, Spinelli Michele
Unit of Neurourology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy.
Unit of Urology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milano, Italy.
Int Neurourol J. 2020 Dec;24(4):382-386. doi: 10.5213/inj.2040096.048. Epub 2020 Dec 31.
Our aim was to report the first case of computer-assisted lead placement (CALP) for a peripheral nerve evaluation (PNE) test in a 55-year-old woman affected by chronic pelvic pain, who was a candidate for sacral neuromodulation (SNM). The first PNE test failed due to nonoptimal lead placement. We utilized a surgical navigation system (SNS) with electromagnetic tracking to guide the lead placement to the S3 right nerve roots. Neither intra- nor postoperative complications occurred. After 2 weeks, the patient reported >50% symptom improvement, so she was recommended to receive a definitive SNM implant. Our case report demonstrated the feasibility and safety of CALP for the PNE test. Since the use of an SNS may guide easy and precise lead placement along the S3 afferent nerve roots, further studies are mandatory to outline the advantages and limits of this innovative technique.
我们的目的是报告首例在一名患有慢性盆腔疼痛、适合接受骶神经调节（SNM）的55岁女性中，使用计算机辅助电极置入（CALP）进行周围神经评估（PNE）测试的病例。首次PNE测试因电极放置不理想而失败。我们使用了带有电磁跟踪的手术导航系统（SNS）来引导电极放置到右侧S3神经根。术中及术后均未发生并发症。2周后，患者报告症状改善超过50%，因此建议她接受确定性的SNM植入。我们的病例报告证明了CALP用于PNE测试的可行性和安全性。由于使用SNS可以沿着S3传入神经根轻松、精确地放置电极，因此必须进一步开展研究以明确这项创新技术的优势和局限性。
