Peripheral nerve stimulation: lead position monitoring by reconstruction CT angiography--a technical report.
BACKGROUND
The authors investigated the possibility of improving positioning of stimulation leads in patients with chronic neuropathic peripheral nerve pain and good pain relief from implantation of a peripheral nerve stimulator (PNS).


METHODS
This pilot study includes four patients suffering from Chronic Regional Pain Syndrome type II (CRPS II) or neuropathic mononeuropathy treated with PNS therapy. The affected extremities and corresponding implantation sites were examined using computer tomographic scans (CT), additional CT angiography (CTA), reconstruction techniques and postprocessing procedures.


RESULTS
It was possible to prove a close relation between the implanted device and the neurovascular bundle in each of these cases. Thus, indirect lead position control was obtained.


CONCLUSIONS
Computer tomographic techniques represent a reliable method for the position control of implanted peripheral nerve electrodes. Hence, this procedure should surpass general radiographies in detecting lead displacements.
Department of Neurosurgery, Neurorothenbaum, Hamburg, Germany. klase@neurorothenbaum.de
Daniel
D
Klase
Arpad
A
Bischof
Goetz
G
Haendler
Sebastian
S
Spuck
Dirk
D
Rasche
Volker
V
Tronnier
D000368:Aged; D000792:Angiography / Q000379:methods*; D001808:Blood Vessels / Q000033:anatomy & histology; D002908:Chronic Disease / Q000628:therapy; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D009437:Neuralgia / Q000503:physiopathology / Q000628:therapy; D019635:Neurosurgical Procedures / Q000379:methods; D010525:Peripheral Nerves / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000601:surgery; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D010865:Pilot Projects; D014057:Tomography, X-Ray Computed / Q000379:methods*