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Computed tomography-guided S3 lead placement for sacral neuromodulation
Christopher P Chung1, Paul A Neese, Hoang Kim Le
1Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Scott and White Healthcare, Texas A&M Health Science Center College of Medicine, 2401 South 31st Street, Temple, TX 76508, USA. cchung@swmail.sw.org
Abstract:
Computed tomography (CT)-guided lead placement for sacral neuromodulation was used in a patient with arthritis and narrow S3 foramina. Bilateral S3 foramina were localized and guide needles were placed with CT guidance. Lead placement was further modified by placement of a tined, quadripolar lead through a dilated S3 tract without initial somatosensory testing. The lead was then interrogated to assess placement and to differentiate superiority of response between two leads. The patient has had greater than 50 % improvement in urinary symptoms by voiding diary. Using CT guidance, satisfactory localization of bilateral S3 foramina may be achieved where prior attempts with conventional fluoroscopy have failed.
