CT-Guided Lead Placement for Selective Sacral Neuromodulation to Treat Lower Urinary Tract Dysfunctions

Abstract

CT-guided tined lead placement was successful in eight patients after 12-month follow-up. Especially in patients with an altered anatomy in the sacral region, this new technique may prevent treatment failure.

Application of an individualized and reassemblable 3D printing navigation template for accurate puncture during sacral neuromodulation

“…In recent years, different medical centers have attempted different guidance methods to improve the success rate and accuracy of lead placement. Meissnitzer et al performed CT‐guided lead placement for selective SNM procedures to treat lower urinary tract dysfunctions and achieved favorable outcomes. In the standardized procedure, C‐arm fluoroscopic guidance can only provide 2D images.…”

International Continence Society best practice statement for use of sacral neuromodulation

“…Some studies suggest that only one active electrode is needed for a clinical response, though most advocate for 4‐electrodes targeted at low voltages . CT guidance has been used for those with complex anatomical findings, while others have shown intra‐operative EMG to be of help . Nevertheless, further outcomes‐based research is needed to clarify the best method for placing the lead (Level of Evidence: III, Grade of Recommendation: C) .…”

Sacral neuromodulation - when and for who

“…Nevertheless, there is an ongoing debate in regard to how accurately the lead must be positioned. There is evidence that suggests that only one active electrode is needed for a proper clinical response (68), but most studies encourage the use of 4-electrodes targeted at low voltages (69). CT supervision could be helpful in those with complex anatomical findings ( 69), but intraoperative EMG may also be of help in specific cases (70).…”