Sacral neuromodulation: sacral anatomy and optimal lead placement.

Journal Article (Journal Article)

INTRODUCTION AND HYPOSTHESIS: 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. METHODS: 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. CONCLUSIONS: 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.

Full Text

Duke Authors

Cited Authors

  • Hendrickson, WK; Amundsen, CL

Published Date

  • September 2021

Published In

Volume / Issue

  • 32 / 9

Start / End Page

  • 2545 - 2547

PubMed ID

  • 33237358

Electronic International Standard Serial Number (EISSN)

  • 1433-3023

Digital Object Identifier (DOI)

  • 10.1007/s00192-020-04615-8


  • eng

Conference Location

  • England