title: Sacral roots stimulation in chronic pelvic pain.
abstract: BACKGROUND
  Chronic pelvic pain is a syndrome of chronic non-malignant pain of multifactorial pathophysiology. Perineal, anal and coccygeal pain can be a form of failed-back surgery syndrome or complex regional pain syndrome. Apart from conservative treatment interventional methods are useful in this condition as neurolytic blocks or non-destructive neuromodulation procedures. Peripheral nerve, spinal cord stimulation or sacral stimulation can be applied.
  
  
  OBJECTIVE
  We describe a minimally invasive method of sacral roots stimulation with percutaneous electrodes implanted through the sacral hiatus in the treatment of chronic pelvic pain.
  
  
  METHODS
  We evaluated a series of nine female patients with pelvic pain treated with sacral roots stimulation in regard of efficacy and complications of this method.
  
  
  RESULTS
  Short-term results in all patients were satisfactory with statistically significant improvement (median VAS=9 before surgery) (median VAS=2 after implantation, p=0.001), (median VAS=3 after 6 months, p=0.043). The long-term follow-up revealed less satisfactory result (median VAS=6 after 12 months). High incidence of complications was noted: mainly infection in 3/9 patients.
  
  
  CONCLUSIONS
  Sacral roots stimulation is a non-destructive and minimally invasive neuromodulation method in the treatment of chronic pelvic pain. It can be effective even in the long-term observation but special care is advised to secure aseptic conditions in the implantation and to prevent the infection which leads to removal of the stimulating system.
authors.affiliation: Department of Neurosurgery, The 10th Military Research Hospital, Bydgoszcz, Poland. Electronic address: psokal@wp.pl.
authors.forename: Paweł
authors.initials: P
authors.lastname: Sokal
authors.affiliation: Department of Neurosurgery, The 10th Military Research Hospital, Bydgoszcz, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Zieliński
authors.affiliation: Department of Neurosurgery, The 10th Military Research Hospital, Bydgoszcz, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Harat
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D055111:Failed Back Surgery Syndrome / Q000628:therapy; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus / Q000503:physiopathology*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010147:Pain Measurement; D017699:Pelvic Pain / Q000628:therapy*; D012189:Retrospective Studies; D013126:Spinal Nerve Roots / Q000503:physiopathology*; D016896:Treatment Outcome
keywords: Chronic pelvic pain; Complex regional pain syndrome; Failed back surgery syndrome; Sacral neuromodulation; Sacral roots stimulation