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Sacral nerve stimulation lead implantation using the O-arm
Pekka A Hellström, Jani Katisko, Pertti Finnilä
1Division of Operative Care and Medical Research Center, Oulu University Hospital, P,O, Box 20, Oulu, FIN 90029 OYS, Finland. markku.vaarala@oulu.fi.
BMC Urology
|October 18, 2013
Summary
This study introduces O-arm guided navigation for sacral neuromodulation lead implantation, proving useful in a challenging case. This advanced imaging technique offers a viable option for complex procedures and reoperations.
Area of Science:
- Medical Imaging
- Neurosurgery
- Surgical Navigation
Background:
- Sacral neuromodulation lead implantation is typically guided by 2D fluoroscopy.
- Obesity and congenital anomalies can complicate sacral nerve stimulation lead placement.
- Surgical navigation and intraoperative imaging offer potential solutions for challenging cases.
Observation:
- A single patient underwent S3 stimulation electrode implantation using an O-arm system under surgical navigation.
- 3D O-arm imaging was performed intraoperatively with automatic registration to the patient's anatomy.
- The stimulation needle and tined lead electrode were guided using the navigation system.
Findings:
- The O-arm clearly visualized sacral bony structures.
- Automatic registration enabled immediate navigation after scanning.
- The procedure was successfully performed under navigation control.
Implications:
- This is the first reported tined lead implantation using surgical navigation and intraoperative O-arm imaging.
- The method aids in demarcating the surgical region, especially in complex anatomies.
- While slightly more invasive, it presents a valuable option for challenging sacral neuromodulation procedures and reoperations, warranting further study.
