Feasibility of Ultrasound-Guided Percutaneous Placement of Peripheral Nerve Stimulation Electrodes and Anchoring During Simulated Movement: Part Two, Upper Extremity

Abstract

This new minimally invasive approach to lead placement requires further study to determine implantation criteria, optimal locations, anchoring techniques, and electrode design to define best clinical practice.

Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation for Postoperative Analgesia

“…23,24 When combined with ultrasound guidance, a lead may be reliably inserted approximately 0.5 to 3.0 cm remote from a peripheral nerve using similar landmarks and general approach as for perineural catheter placement. [25][26][27] Ultrasound-guided pPNS was first reported in situ by Huntoon and Burgher 28 in 2009 using an epidural neurostimulation electrode for the treatment of chronic neuropathic pain. Although similar techniques were subsequently reported for additional chronic pain conditions, [29][30][31] it had yet to be applied to a postoperative pain state.…”

Challenges of Peripheral Nerve Stimulator Implantation in a Patient with New Onset Thrombocytopenia

“…Peripheral nerve stimulator trials using SCS leads under ultrasound guidance for placement allows for sensory and motor testing whereas motor testing for open neurosurgical approach involves a wake up test. Another advantage for using SCS leads for field block is the decreased risk of mechanical nerve injury as seen with flat surgical plate electrodes [7,8].…”

Percutaneous Peripheral Neuromodulation Lead Insertion Using a Novel Stimulating Coudé Needle

“…The correct sensory and, if required, motor response provides the best functional confirmation of successful location of device leads in the required area. Ultrasound and fluoroscopy add an anatomical view of lead position (26)(27)(28)(29), but the correct endpoint is coverage of the painful area by stimulation rather than strict anatomical placement. As the stimulating needle is large and therefore easily visualized on ultrasound, combining both stimulating and image-guided techniques will further improve safety.…”