Percutaneous retroperitoneal stimulation of the sacral plexus. Initial report and technical note.
A new percutaneous approach to stimulate the sacral plexus for the treatment of pain is described. The percutaneous electrode is inserted under fluoroscopy through the chosen dorsal and ventral sacral foramen and is advanced into the retroperitoneal layer where the plexus lies. The electrode, can be advanced several centimeters and lies in close proximity to the branches of the sacral plexus. Both motor and sensory responses can be elicited with electrical stimulation. Our initial experience with 4 implanted patients is presented and discussed. Several areas of the nervous system have been target for implantation of stimulating and recording electrodes for management of pain, as well as other indications. This includes parts of the cerebrum, brainstem, spinal cord and peripheral nerves. We report our initial experience with a new approach to stimulation of the peripheral nervous structures. That is stimulation of the sacral plexus through electrodes implanted percutaneously along the plexus in the retroperitoneal area. This initial report is not meant to give clinical results of this methodology, but simply to point to another route to apply electrical stimulation safely to various parts of the nervous system.
Barolat
G
G
Division of Functional Neurosurgery, Thomas Jefferson University, Philadelphia, Pa.
D000698:Analgesia / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008160:Lumbosacral Plexus / Q000033:anatomy & histology*; D010148:Intractable Pain / Q000628:therapy; D012187:Retroperitoneal Space; D004561:Transcutaneous Electric Nerve Stimulation