Percutaneous Peripheral Neuromodulation Lead Insertion Using a Novel Stimulating Coude Needle

摘要

The initial open approach to peripheral nerve stimulation was associated with significant morbidity, complications, and reports of low efficacy (1-4). Attempts to address these problems led to the development of a percutaneous approach using small cylindrical electrodes. The use of peripheral nerve stimulation in treating chronic neuropathic pain states has seen a resurgence since Weiner and Reed successfully implanted percutaneous occipital nerve stimulator electrodes in 1999 (5). This percutaneous technique of electrode insertion allows minimally invasive placement of stimulating electrodes and enables access to novel areas of stimulation, such as single nerves, previously the exclusive domain of surgery (6,7); the nerve plexus (8); subcutaneous targets/field (9-12); or the sympathetic chain (13,14). These advantages have led to an increase in its popularity, allowing treatment of chronic pain states either as a standalone treatment or in combination with spinai cord stimulation (15-18).