title: Novel tunneling system for implantation of percutaneous nerve field stimulator electrodes: a technical note.
abstract: BACKGROUND
  The field of neuromodulation continues to grow, especially in the area of pain management. Percutaneous nerve field stimulation continues to gain significant popularity for chronic, focal, and intractable neuropathic pain.
  
  
  METHODS
  Tuohy needles have been traditionally used as the instrument of choice for subcutaneous implantation of peripheral field stimulators. The ON-Q® Tunneling System (Braun Melsungen AG, Melsungen, Germany) provides an adaptable option for subcutaneous implantation of electrodes, with a variety of lengths and gauges available. This system uses a disposable blunt needle and a peel-away sheath and is firm but malleable. Gentle curves can be applied to the stylet prior to implantation. The blunt, malleable nature of the needle and the soft Silastic sheath allow for applications in areas with greater curvature, such as the face, and ensure a subcutaneous placement.
  
  
  CONCLUSIONS
  The great adaptability of this system allows for implantation of electrodes subcutaneously with efficacy and ease. Here we present a technical note on the use of this system for subcutaneous implantation of peripheral nerve field stimulators.
authors.affiliation: Center for Neuromodulation, Department of Neurological Surgery, Ohio State University Wexner Medical Center, Columbus, OH, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Shaw
authors.affiliation: Center for Neuromodulation, Department of Neurological Surgery, Ohio State University Wexner Medical Center, Columbus, OH, USA.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mohyeldin
authors.affiliation: Center for Neuromodulation, Department of Neurological Surgery, Ohio State University Wexner Medical Center, Columbus, OH, USA.
authors.forename: Zion
authors.initials: Z
authors.lastname: Zibly
authors.affiliation: Center for Neuromodulation, Department of Neurological Surgery, Ohio State University Wexner Medical Center, Columbus, OH, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ikeda
authors.affiliation: Center for Neuromodulation, Department of Neurological Surgery, Ohio State University Wexner Medical Center, Columbus, OH, USA.
authors.forename: Milind
authors.initials: M
authors.lastname: Deogaonkar
mesh_terms: D002408:Catheters, Indwelling; D004567:Electrodes, Implanted; D006801:Humans; D009437:Neuralgia / Q000628:therapy; D059408:Pain Management / Q000295:instrumentation*; D004561:Transcutaneous Electric Nerve Stimulation / Q000295:instrumentation* / Q000379:methods*
keywords: Neuromodulation; ON-Q needle; peripheral field stimulation; tunneler