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Creating a Strain Relief Loop during S1 Transforaminal Lead Placement for Dorsal Root Ganglion Stimulation for Foot Pain: A Technical Note
Author(s) -
Velsen Valery,
Helmond Noud,
Chapman Kenneth B.
Publication year - 2018
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12638
Subject(s) - medicine , dorsal root ganglion , lead (geology) , strain (injury) , stimulation , pain relief , neuropathic pain , deep brain stimulation , ganglion , dorsum , chronic pain , surgery , loop (graph theory) , anesthesia , physical therapy , anatomy , disease , geomorphology , parkinson's disease , mathematics , combinatorics , geology
Abstract 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.