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Novel Surgical Rodent Model for Studying Neuroma Pain Treatment Options using Targeted Muscle Reinnervation Through the Saphenous Nerve

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Third sacral foramina morphometry for sacral neuromodulation.

Mona C McCullough¹, Summer Decker, Jonathan Ford

¹University of South Florida, Tampa, FL, USA. mona_mccullough@yahoo.com

Female Pelvic Medicine & Reconstructive Surgery

|January 17, 2013

Summary

This summary is machine-generated.

This study precisely maps the S3 foramen using CT scans, providing key bony landmarks for accurate sacral neuromodulator needle placement and improving procedure success rates.

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Area of Science:

Anatomy
Medical Imaging
Surgical Navigation

Background:

Accurate S3 foramen localization is crucial for effective sacral neuromodulation.
Current methods for identifying the S3 foramen can be challenging due to anatomical variations.

Purpose of the Study:

To define the precise geometry and location of the human S3 foramen.
To establish reliable bony landmarks for ultrasound-guided S3 foramen identification.

Main Methods:

Analysis of 133 de-identified pelvic CT scans.
Mathematical determination of S3 foramina geometry relative to sacral hiatus, spinous processes, and the SI line.
Exclusion of scans with pelvic bone abnormalities.

Main Results:

The SI line (caudal aspect of SI joints) is a superior landmark for S3 localization compared to the sacral hiatus.
Approximately 14% of S3 foramina extend cephalad to the SI line.
The S3 foramen trajectory averages a 70-degree sagittal angle relative to the dorsal sacrum.

Conclusions:

Optimal S3 foramen needle placement involves positioning 15-25 mm lateral to spinous processes and 0-25 mm caudal to the SI line.
These findings enhance the accuracy and efficacy of sacral neuromodulator lead placement.
The study validates the crosshair placement technique and guides needle repositioning.