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Creating a Strain Relief Loop during S1 Transforaminal Lead Placement for Dorsal Root Ganglion Stimulation for Foot Pain: A Technical Note.
Pain Pract 2018; 18(4):539-543PP

Abstract

Chronic neuropathic pain is often refractory to conventional medical treatments and leads to significant disability and socio-economic burden. Dorsal root ganglion (DRG) stimulation has recently emerged as a treatment for persistent neuropathic pain, but creating a strain relief loop at the S1 level has thus far been a challenging technical component of DRG lead placement. We describe a refined technique for strain relief loop formation at the S1 level using a transforaminal approach that we employed in a 45-year-old patient with intractable foot pain. We successfully placed a strain relief loop in the sacral space in a predictable and easily reproducible manner using a transforaminal anchorless approach. The patient experienced a decrease in visual analog pain score (85%), and improvement in function during the trial period, and proceeded with permanent implantation. The described sacral transforaminal strain relief loop formation technique appears to be a more reliable and predictable technique of DRG lead placement in the sacrum than those previously documented.

Authors+Show Affiliations

Radboud University Medical Center, Nijmegen, the Netherlands.Spine & Pain Institute of New York, New York City, New York, U.S.A.Spine & Pain Institute of New York, New York City, New York, U.S.A. Department of Anesthesiology, New York University Langone Medical Center, New York City, New York, U.S.A. Department of Pain Medicine, Northwell Health System, New York City, New York, U.S.A.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

28862789

Citation

van Velsen, Valery, et al. "Creating a Strain Relief Loop During S1 Transforaminal Lead Placement for Dorsal Root Ganglion Stimulation for Foot Pain: a Technical Note." Pain Practice : the Official Journal of World Institute of Pain, vol. 18, no. 4, 2018, pp. 539-543.
van Velsen V, van Helmond N, Chapman KB. Creating a Strain Relief Loop during S1 Transforaminal Lead Placement for Dorsal Root Ganglion Stimulation for Foot Pain: A Technical Note. Pain Pract. 2018;18(4):539-543.
van Velsen, V., van Helmond, N., & Chapman, K. B. (2018). Creating a Strain Relief Loop during S1 Transforaminal Lead Placement for Dorsal Root Ganglion Stimulation for Foot Pain: A Technical Note. Pain Practice : the Official Journal of World Institute of Pain, 18(4), pp. 539-543. doi:10.1111/papr.12638.
van Velsen V, van Helmond N, Chapman KB. Creating a Strain Relief Loop During S1 Transforaminal Lead Placement for Dorsal Root Ganglion Stimulation for Foot Pain: a Technical Note. Pain Pract. 2018;18(4):539-543. PubMed PMID: 28862789.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Creating a Strain Relief Loop during S1 Transforaminal Lead Placement for Dorsal Root Ganglion Stimulation for Foot Pain: A Technical Note. AU - van Velsen,Valery, AU - van Helmond,Noud, AU - Chapman,Kenneth B, Y1 - 2017/12/06/ PY - 2017/07/03/received PY - 2017/08/06/revised PY - 2017/08/27/accepted PY - 2017/9/2/pubmed PY - 2017/9/2/medline PY - 2017/9/2/entrez KW - Dorsal root ganglion stimulation KW - chronic pain KW - strain relief loop SP - 539 EP - 543 JF - Pain practice : the official journal of World Institute of Pain JO - Pain Pract VL - 18 IS - 4 N2 - Chronic neuropathic pain is often refractory to conventional medical treatments and leads to significant disability and socio-economic burden. Dorsal root ganglion (DRG) stimulation has recently emerged as a treatment for persistent neuropathic pain, but creating a strain relief loop at the S1 level has thus far been a challenging technical component of DRG lead placement. We describe a refined technique for strain relief loop formation at the S1 level using a transforaminal approach that we employed in a 45-year-old patient with intractable foot pain. We successfully placed a strain relief loop in the sacral space in a predictable and easily reproducible manner using a transforaminal anchorless approach. The patient experienced a decrease in visual analog pain score (85%), and improvement in function during the trial period, and proceeded with permanent implantation. The described sacral transforaminal strain relief loop formation technique appears to be a more reliable and predictable technique of DRG lead placement in the sacrum than those previously documented. SN - 1533-2500 UR - https://www.unboundmedicine.com/medline/citation/28862789/Creating_a_Strain_Relief_Loop_during_S1_Transforaminal_Lead_Placement_for_Dorsal_Root_Ganglion_Stimulation_for_Foot_Pain:_A_Technical_Note_ L2 - https://doi.org/10.1111/papr.12638 DB - PRIME DP - Unbound Medicine ER -