Open AccessAlternative Approach To Needle Placement In Cervical Spinal Cord Stimulator Insertion
Author(s) -
Jie Zhu
Publication year - 2011
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2011/14/195
Subject(s) - medicine , spinal cord stimulator , interventional pain management , fluoroscopy , percutaneous , neuromodulation , surgery , spinal cord , epidural space , occipital nerve stimulation , chronic pain , radiology , spinal cord stimulation , physical therapy , stimulation , psychiatry , alternative medicine , pathology
Background: Neuromodulation with spinal cord stimulation is a proven costeffective treatment for the management of common conditions such as chronicradicular leg pain from failed back surgery syndrome, complex regional painsyndrome, and other painful neuropathic pain syndromes. The traditionallyinstructed method for percutaneous spinal cord stimulator (SCS) lead placementpromotes the use of a “loss of resistance” (LOR) technique under anteroposterior(AP) fluoroscopic guidance to assure midline lead placement and proper entryinto the epidural space.Objective: To describe the relevant anatomy and method for a preciseneedle placement approach for placement of percutaneous cervical spinal cordstimulation (SCS) leads without loss of resistance (LOR) using a syringe. Anoblique fluoroscopic view is presented demonstrating successful placement ofcervical SCS leads.Design: Technical report.Setting: Pain management clinic.Methods: Discussion with accompanying fluoroscopic images. This technicalreport meets HIPAA compliance standards.Results: Successful placement of percutaneous SCS leads without traditionalloss of resistance using an oblique fluoroscopic approach.Limitations: Technical report only. The risks, potential complications, andbenefit from this approach are beyond the scope of the article.Conclusions: This fluoroscopic technique provides an alternative means forplacing percutaneous cervical SCS leads without the use of the traditional loss ofresistance technique.Key words: spinal cord stimulation, neuromodulation, cervical spine, fluoroscopy,loss of resistance, epidural injection, neuropathic pain, failed neck surgery.