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Related Experiment Videos

Sacral-neuromodulation CT-guided.

Lamberto Amoroso1, Giuseppe Pelliccioni, Roberto Ghiselli

  • 1Dipartimento di Radiologia e Medicina Nucleare, Ancona, Italy. l.amoroso@inrca.it

La Radiologia Medica
|May 11, 2005
PubMed
Summary

Computed tomography (CT) guidance offers an effective alternative for Percutaneous Nerve Evaluation (PNE) testing in sacral neuromodulation. This advanced imaging improves accuracy and efficiency for treating refractory voiding disorders.

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Area of Science:

  • Neurology
  • Urology
  • Medical Imaging

Background:

  • Sacral neuromodulation is a treatment for refractory voiding disorders like incontinence and retention.
  • The standard Percutaneous Nerve Evaluation (PNE) test uses fluoroscopy, which has limitations including radiation exposure and visualization issues.
  • Alternative methods are sought to improve the efficiency and safety of PNE testing.

Purpose of the Study:

  • To evaluate the use of computed tomography (CT) as an alternative guidance technique for the PNE test.
  • To assess the advantages and potential for routine use of CT-guided PNE.

Main Methods:

  • Thirty patients with refractory pelvic disorders underwent PNE testing using CT guidance.
  • CT volumetric scanning identified sacral foramina, with 3D reconstructions aiding visualization.

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  • Spinal needles and electrodes were precisely positioned under CT control, with checks for correct muscular response.

    • Main Results:

    • CT guidance successfully centered the sacral foramen in 36 out of 38 attempts (94.7%).
    • The procedure was well-tolerated, with no infectious complications reported.
    • CT guidance facilitated electrode placement in a patient with sacral malformation, a challenging case for fluoroscopy.

    Conclusions:

    • CT-guided PNE is an effective and accurate alternative to fluoroscopy for sacral neuromodulation.
    • This technique offers improved visualization and precision, especially in cases with anatomical variations.
    • CT guidance shows promise for routine use in PNE testing, enhancing patient care for voiding disorders.