Surface and Boney Landmarks for Sacral Neuromodulation: A Cadaveric Study

Deveneau, Nicolette E.; Greenstein, Miriam; Mahalingashetty, Abhijit; Herring, Nicole R.; Lipetskaia, Lioudmila; Azadi, Ali; Ostergard, Donald R.; Francis, Sean L.

doi:10.1016/j.jmig.2013.12.113

Cited by 5 publications

(17 citation statements)

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“…If one relies on bony landmarks alone, lead placement could easily be at S2 or S4 in some of these patients. Similar observations have been made in relation to the distance from the midline to the foraminal edge . This individual variability illustrates the disadvantages of using “thumb rules” and highlights the need for proper measurement in each individual, which can only be done with x‐ray.…”

Section: Resultssupporting

confidence: 67%

“…Although these bony landmarks can usually be identified easily, the operator's experience is essential for correct positioning, as the orientation of the sacral bone and the amount of subcutaneous fatty tissue varies among individuals. Indeed, cadaver studies have shown large variability in size and distance of bony sacral landmarks: e.g., the distance from the upper part of the S3 foramen to the tip of the coccyx has a mean of 9.26 cm, but in only 18 cadavers the range was 3.4 cm . If one relies on bony landmarks alone, lead placement could easily be at S2 or S4 in some of these patients.…”

Section: Resultsmentioning

confidence: 99%

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Sacral Neuromodulation: Standardized Electrode Placement Technique

Matzel

Chartier‐Kastler

Knowles

et al. 2017

Neuromodulation: Technology at the Neural Interface

149

126

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Section: Resultssupporting

confidence: 67%

Section: Resultsmentioning

confidence: 99%

Sacral Neuromodulation: Standardized Electrode Placement Technique

Matzel

Chartier‐Kastler

Knowles

et al. 2017

Neuromodulation: Technology at the Neural Interface

149

126

View full text Add to dashboard Cite

show abstract

“…In a study conducted by Deveneau et al [19], the mean height of the subjects was found to be 163.7 cm with a standard deviation of ±10.3 cm. In male cadavers, it was found to be 170.8 cm, with a standard deviation of ±5.2 cm.…”

Section: Discussionmentioning

confidence: 93%

“…In the study conducted by Deveneau et al [19], a mean needle tip to a superior aspect of S3 was measured to be 1.2 ± 1.3 cm. In males, it was found to be 1.1 ± 1.1 cm, and in females, it was found to be 1.4 ± 1.5 cm, and the mean tip of the coccyx to the superior aspect of S3 was found to be 9.3 ± 0.9 cm.…”

Section: Discussionmentioning

confidence: 96%

A Cadaveric Study on the Efficacy of Surface Marking and Bony Landmarks Used in Sacral Neuromodulation

Almutairi

2020

Cureus

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Background Anatomical landmarks and surface markings have long been used in outpatient contexts for conducting percutaneous nerve evaluation procedures, but studies testing the reliability of these anatomical landmarks are scant. There have been reports where the procedure has failed. Could it be possible that the anatomical landmarks that are used are not reliable enough? To answer this question, we used this study to understand the reliability of these anatomical landmarks. Methods Twenty cadavers, 10 males and 10 females, were dissected in the sacral region; the landmarks were tested, and the angulation and curve made by the sacral 3 (S3) nerve were also studied. Results Sacral 3 was identified mainly at the four o'clock position on the right and at the eight o'clock position on the left side. The Sacral 3 foramen was found at a mean distance of 9.17 ± 0.23 cm from the tip of the coccyx. The mean distance of the lateral margin of S3 from the median sacral ridge was found to be 2.16 ± 0.07 cm. Conclusion The landmark of 9 cm from the coccyx tip is a valid landmark for sacral neuromodulation (SNM) procedures. The tip of the lead should follow the curve of the nerve as close as possible at the four and eight o'clock positions on the right and left side, respectively. However, the length of the coccyx differs from person to person. The proximity of the adjacent foramina to each other and the variations in the emerging of the nerve are a few factors to be considered while performing SNM procedures. Further study with a larger sample is required in order to investigate the course of the nerve, and its relationship to response to SNM.

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“…In the prone position, a needle harboring a single-electrode lead is advanced to correctly identify the S3 foramen. The S3 foramen can be identified fluoroscopically, or approximated anatomically as evident from cadaveric studies that showed the mean distance of the superior aspect of the S3 foramen is approximately cm from the coccyx, and laterally it is 2 cm from the middle of the sacral back region, while vertical interforamenal spaces are around 1.5 cm in length [59].…”

Section: Office-based Percutaneous Nerve Evaluationmentioning

confidence: 99%

Neuromodulation in Urology: Current Trends and Future Applications

Yaiesh¹,

Al‐Terki²,

Al-Shaiji³

2020

Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice

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Urological applications of neuromodulation and neurostimulation are among the most evolving fields for these technologies. First approved for management of refractory urge incontinence, different modalities of neuromodulation and stimulation have been tested, applied and verified for a vast spectrum of voiding and pelvic floor dysfunction disorders. The modalities of delivering this treatment have also evolved in the last three decades, with a focus on sacral neuromodulation. The experimental and established "off-label" applications of neuromodulation have also encompassed chronic pelvic pain disorders, including chronic prostatitis and bladder pain syndrome, among others. In this chapter, we discuss all the hypothesized theories suggested on how this technology provides therapeutic potential for a number of chronic and debilitating urological conditions, the modes of delivery be it anterior, sacral, and posterior tibial to name a few, and the evolving and future applications.

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Surface and Boney Landmarks for Sacral Neuromodulation: A Cadaveric Study

Cited by 5 publications

References 0 publications

Sacral Neuromodulation: Standardized Electrode Placement Technique

Sacral Neuromodulation: Standardized Electrode Placement Technique

A Cadaveric Study on the Efficacy of Surface Marking and Bony Landmarks Used in Sacral Neuromodulation

Neuromodulation in Urology: Current Trends and Future Applications

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