An Anatomy-Informed, Novel Technique for S1 Dorsal Root Ganglion Stimulation Lead Placement

Chapman, Kenneth B.; Helmond, Noud van; Kallewaard, Jan Willem; Vissers, Kris; Patel, Kiran V; Motivala, Soriaya; Hagedorn, Jonathan M; Deer, Timothy R; Dickerson, David

doi:10.1093/pm/pnac062

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…These needles demarcate a safety boundary lateral to the sacral foramen, and their tips demarcate the osseous border of the posterior sacrum. [ 14 ] (Fig. 1 B).…”

Section: Techniquementioning

confidence: 99%

Sacroiliac Joint Denervation—A Novel Approach to Target Sacral Lateral Branches: A Practical Approach

Silva-Ortiz,

Chapman,

Chang Chien

et al. 2024

Pain Ther

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Introduction Sacroiliac joint (SIJ) pain is a relatively common cause of low back pain. Percutaneous radiofrequency (RF) techniques for SIJ are limited to ablation of the posterior SIJ innervation. Different techniques have been described for SIJ radiofrequency ablation, including conventional thermal, cooled RF, pulsed RF, bipolar RF, and specialized tip RF needle (i.e., multi-tined); however, additional costs may limit these applications. Methods This new technique for SIJ denervation uses anatomical landmarks and a single RF cannula. Two spinal needles are placed lateral to the posterior S1 and S2 sacral foramina; then, with caudal tilt we get a coaxial view of the sacral bone, we advance an 18-G curved 15-mm active tip RF cannula just lateral to the aligned finder needles. Ablation is performed, and then the RF cannula is retracted 2 cm and ablation is repeated for a total of four lesions. Results The two spinal needles placed lateral to the posterior sacral foramina S1 and S2 guide the final needle in the posterior aspect of the sacrum, lateral to the sacral foramina, where the lateral sacral branches are located. Conclusion We introduce a cost and time efficient technique to perform radiofrequency ablation of the sacral lateral branches using a single RF needle. This technique utilizes the sacrum’s reliable anatomy and angulation and maximizes the surface area of the active tip lesioning. This technique creates a strip lesion lateral to the sacral foramina and reduces time and cost efficacy compared to several of the other techniques and/or commercially available special devices designed for sacroiliac denervation.

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“…These needles demarcate a safety boundary lateral to the sacral foramen, and their tips demarcate the osseous border of the posterior sacrum. [ 14 ] (Fig. 1 B).…”

Section: Techniquementioning

confidence: 99%

Sacroiliac Joint Denervation—A Novel Approach to Target Sacral Lateral Branches: A Practical Approach

Silva-Ortiz,

Chapman,

Chang Chien

et al. 2024

Pain Ther

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“…195 A recently described technique using measurements for sacral lead placement was designed to avoid these issues. 196 See Figure 10.…”

Section: Sacral Anatomy Relevant To Drg-s Placementmentioning

confidence: 99%

Best Practices for Dorsal Root Ganglion Stimulation for Chronic Pain: Guidelines from the American Society of Pain and Neuroscience

Chapman¹,

Sayed²,

Lamer³

et al. 2023

JPR

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With continued innovations in neuromodulation comes the need for evolving reviews of best practices. Dorsal root ganglion stimulation (DRG-S) has significantly improved the treatment of complex regional pain syndrome (CRPS), and it has broad applicability across a wide range of other conditions. Through funding and organizational leadership by the American Society for Pain and Neuroscience (ASPN), this best practices consensus document has been developed for the selection, implantation, and use of DRG stimulation for the treatment of chronic pain syndromes. This document is composed of a comprehensive narrative literature review that has been performed regarding the role of the DRG in chronic pain and the clinical evidence for DRG-S as a treatment for multiple pain etiologies. Best practice recommendations encompass safety management, implantation techniques, and mitigation of the potential complications reported in the literature. Looking to the future of neuromodulation, DRG-S holds promise as a robust intervention for otherwise intractable pain.

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Dorsal root ganglion stimulation for low back pain

Chapman,

Dickerson,

Yang

et al. 2025

How to Treat Low Back Pain

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An Anatomy-Informed, Novel Technique for S1 Dorsal Root Ganglion Stimulation Lead Placement

Cited by 4 publications

References 29 publications

Sacroiliac Joint Denervation—A Novel Approach to Target Sacral Lateral Branches: A Practical Approach

Sacroiliac Joint Denervation—A Novel Approach to Target Sacral Lateral Branches: A Practical Approach

Best Practices for Dorsal Root Ganglion Stimulation for Chronic Pain: Guidelines from the American Society of Pain and Neuroscience

Dorsal root ganglion stimulation for low back pain

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