Santiago Natally, Monaco Bernardo A, Santos Piedade Guilherme, Jagid Jonathan, Cordeiro Joacir G
Neurological Surgery, Beneficência Portuguesa de São Paulo, São Paulo, BRA.
Neurological Surgery, University of Miami, Miami, USA.
Cureus. 2023 Jul 10;15(7):e41663. doi: 10.7759/cureus.41663. eCollection 2023 Jul.
Sacral stimulation is a well-established therapy for urologic neuromodulation. After the advent of dorsal root ganglion (DRG) stimulation, pain surgeons have started to reach this target mostly for pelvic and sacral pain. For those without good surgical experience, sacral foramen puncture, especially S3 and S4, can be a challenge, due to its entry angle and limited C-arm image resolution. In this report, we describe a new technique to utilize sacral navigation using the O-arm approach to guide DRG stimulation implants. We discuss a case of a 53-year-old male patient with refractory coccygodynia, who underwent sacral DRG implantation using neuronavigation. Punctures could be done without the need for multiple attempts to reach the foramen in this patient.
骶神经刺激是一种成熟的泌尿外科神经调节疗法。在背根神经节(DRG)刺激出现后,疼痛外科医生开始主要针对盆腔和骶部疼痛来实现这一目标。对于那些没有丰富手术经验的人来说,骶孔穿刺,尤其是S3和S4穿刺,由于其进针角度和C形臂图像分辨率有限,可能具有挑战性。在本报告中,我们描述了一种利用O形臂方法进行骶神经导航以指导DRG刺激植入物的新技术。我们讨论了一例53岁男性难治性尾骨痛患者,他接受了使用神经导航的骶部DRG植入术。该患者无需多次尝试即可完成穿刺到达骶孔。