Peripheral Nerve Stimulation for Chronic Shoulder Pain: A Proof of Concept Anatomy Study

Although spinal cord and dorsal root ganglia stimulation may be effective for managing regional pain syndromes, a more targeted approach is perhaps more appealing for discrete anatomical structures. Chronic shoulder pain is a common musculoskeletal problem with significant socioeconomic impact. A peripheral nerve stimulation of the axillary and suprascapular nerves may prove to be effective as a long-term solution for this indication. In anticipation of the future experimental research and clinical utilization, a sound methodology for the lead placement was developed, and its feasibility is tested in a cadaveric study.

Normal anatomy was corroborated with ultrasound scans of live models and cadaver specimens. A step-by-step ultrasound-guided implantation technique was designed. The procedure was completed targeting both the axillary and suprascapular nerves. The accuracy of the lead placement was confirmed by dissections.

The implanted devices were found adjacent to the target nerves within 0.5-1 cm distance.

The anatomical dissections confirmed the accuracy of ultrasound-guided placement of the lead. The described method is based on normal anatomy and appeared to be reproducible by following the outlined procedural steps.