Neurostimulation of sacral roots through the sacral hiatus: new therapeutic horizons?
DOI:
https://doi.org/10.47924/neurotarget2023459Keywords:
Coccygodinia, pelvic pain, sacroiliac pain, sacral root stimulationAbstract
Anatomical approaches to sacral nerve stimulation, including transsacral, retrograde, and anterograde (caudal) techniques, have been extensively documented in managing urological disorders. However, their application in non-urological conditions is an emerging area of clinical interest with promising outcomes.
This study presents a retrospective case series involving three patients suffering from chronic pain conditions (perineal pain, coccydynia, and sacroiliac pain), who underwent sacral root stimulation via the sacral hiatus. Following neurostimulator implantation, all patients reported substantial pain relief, reduced analgesic usage, and improved quality of life, including better functional capacity and emotional well-being.
These findings highlight the potential for broader use of sacral root stimulation in treating perineal and sacral pain, advocating for further investigation into its expanding therapeutic applications.
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Kohli N, Rosenblatt PL. Neuromodulation techniques for the treatment of the overactive bladder. Clin Obstet Gynecol 2002; 45: 218-32.
Chodez M, Trilling B, Thuillier C, Boillot B, Barbois S, Faucheron JL. Results of sacral nerve neuromodulation for ouble incontinence in adults. Tech Coloproctol 2014; 18:1147-51.
Steinberg AC, Oyama IA, Whitmore KE. Bilateral S3 stimulator in patients with interstitial cystitis. Urology 2007; 69: 441-3.
El-Gazzaz G, Zutshi M, Salcedo L, Hammel J, Rackley R, Hull T. Sacral neuromodulation for the treatment of fecal incontinence and urinary incontinence in female patients: long-term follow-up. Int J Colorectal Dis 2009; 24: 1377-81.
Buffenoir K, Rioult B, Hamel O, Labat JJ, Riant T, Robert R. Spinal cord stimulation of the conus medullaris for refractory pudendal neuralgia: a prospective study of 27 consecutive cases. Neurourol Urodyn 2015; 34: 177-82.
Hunter C, Davé N, Diwan S, Deer T. Neuromodulation of pelvic visceral pain: review of the literature and case series of potential novel targets for treatment. Pain Pract 2013; 13: 3-17.
Kim JH, Hong JC, Kim MS, Kim SH. Sacral nerve stimulation for treatment of intractable pain associated with cauda equina syndrome. J Korean Neurosurg Soc 2010; 47: 473-6
Feler CA, Whitworth LA, Fernandez J. Sacral neuromodulation for chronic pain conditions. Anesthesiol Clin North America 2003; 21: 785-95
Hunter C, Davé N, Diwan S, Deer T. Neuromodulation of pelvic visceral pain: review of the literature and case series of potential novel targets for treatment. Pain Pract 2013; 13: 3-17.
Kim JH, Hong JC, Kim MS, Kim SH. Sacral nerve stimulation for treatment of intractable pain associated with cauda equina syndrome. J Korean Neurosurg Soc 2010; 47: 473-6.
Park, C. H., & Kim, B. I. (2012). Sacral nerve stimulation through the sacral hiatus. The Korean Journal of Pain, 25(3),195-197. https://doi.org/10.3344/kjp.2012.25.3.195
Vancaillie T, Kite L, Howard E, Chow J. Sacral neuromodulation for pelvic pain and pelvic organ dysfunction: A case series. Aust N Z J Obstet Gynaecol. 2018;58(1):102-7. http://dx.doi.org/10.1111/ajo.12752
Calvillo O, Esses SI, Ponder C, DʼAgostino C, Tanhui E. Neuroaugmentation in the management of sacroiliac joint pain: Report of two cases. Spine (Phila Pa 1976) [Internet]. 1998;23(9):1069-72. Available from: http://dx.doi.org/10.1097/00007632-199805010-00022
Kim YH, Moon DE. Sacral nerve stimulation for the treatment of sacroiliac joint dysfunction: A case report: Neuromodulation in sij dysfunction. Neuromodulation [Internet]. 2010;13(4):306-10. Available from: http://dx.doi.org/10.1111/j.1525-1403.2009.00270.x
Hope ER, Gruber DD. Coccygeal fracture pain cured by sacral neuromodulation: a case report: Letter to the editor. Neuromodulation [Internet]. 2013;16(6):614-7. Available from: http://dx.doi.org/10.1111/ner.12002
Guardo LA, Gala CC, Poveda DS, Juan PR, Montero FJS, Sánchez JCG, et al. Caudal neuromodulation with the transforaminal sacral electrode (InterStim?): Experience in a pain center regarding 12 implants. Korean J Pain [Internet]. 2016;29(1):23-8. Available from: http://dx.doi.org/10.3344/kjp.2016.29.1.23
Lee DW, Lai A. Sacral burst neuromodulation via caudal approach as a treatment for chronic coccydynia: Letter to the editor. Neuromodulation [Internet]. 2019;22(8):992-4. Available from: http://dx.doi.org/10.1111/ner.12808
Feler CA, Whitworth LA, Fernandez J. Sacral neuromodulation for chronic pain conditions. Anesthesiol Clin North America [Internet]. 2003;21(4):785-95. Available from: http://dx.doi.org/10.1016/s0889-8537(03)00085-3
Lavano A, Volpentesta G, Piragine G, Iofrida G, De Rose M, Abbate F, et al. Sacral nerve stimulation with percutaneous dorsal transforamenal approach in treatment of isolated pelvic pain syndromes: Transforamenal SNS in pelvic pain syndromes. Neuromodulation [Internet]. 2006;9(3):229–33. Available from: http://dx.doi.org/10.1111/j.1525-1403.2006.00064.x
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