Skip to main content

Percutaneous Sacral Nerve Stimulation

  • Chapter
  • First Online:
  • 148 Accesses

Abstract

Pelvic pain is a poorly understood phenomenon that is notoriously difficult to treat. Conservative treatment modalities like medication and nerve blocks are largely ineffective in this particular patient population rendering most of these patients debilitated and suffering. Spinal cord stimulation would seem to be the logical treatment option for these recalcitrant cases, and given the predominance of sacral innervation in the pelvic viscera, targeting the sacral nerve themselves for direct stimulation is obvious choice. Percutaneous sacral nerve stimulation (SNS) is a therapeutic option pelvic pain with demonstrated efficacy. In this chapter we present an overview of the implementation and the supporting evidence.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Recommended Reading

  1. Alo K, Yland M, Redko V, Feler C, Naumann C. Lumbar and sacral nerve root stimulation (NRS) in the treatment of chronic pain: a novel anatomic approach and neuro stimulation technique. Neuromodulation. 1999;2(1):23–31.

    Article  CAS  Google Scholar 

  2. Alo` KM, McKay E. Selective nerve root stimulation (SNRS) for the treatment of intractable pelvic pain and motor dysfunction: a case report. Neuromodulation. 2001;4(1):19–23.

    Article  CAS  Google Scholar 

  3. Alo` KM, Yland MJ, Redko V, Feler C, Naumann C. Lumbar and sacral nerve root stimulation (NRS) in the treatment of chronic pain: a novel anatomic approach and neurostimulation technique. Neuromodulation. 1999;2:23–31.

    Article  CAS  Google Scholar 

  4. Brookoff D, Bennett D. Neuromodulation in intractable interstitial cystitis and related pelvic pain syndromes. Pain Med. 2006;7(suppl 1):S166–84.

    Article  Google Scholar 

  5. Deer T, Lamer T, Pope J, Falowski S, Provenzano D, Slavin K, Golovac S, Arle J, Rosenow J, Williams K, McRoberts P, Narouze S, Eldabe S, Lad S, De Andrés J, Buchser E, Rigoard P, Levy R, Simpson B, Mekhail N. The neurostimulation appropriateness consensus committee (NACC) safety guidelines for the reduction of severe neurological injury. Neuromodulation Technol Neural Interface. 2017;20(1):15–30.

    Article  Google Scholar 

  6. Deer T, et al. The neurostimulation appropriateness consensus committee (NACC) recommendations for infection prevention and management. Neuromodulation Technol Neural Interface. 2017;20(5):516.

    Article  Google Scholar 

  7. Deer T, et al. The neurostimulation appropriateness consensus committee (NACC): recommendations on bleeding and coagulation management in neurostimulation devices. Neuromodulation Technol Neural Interface. 2017;20(4):407.

    Article  Google Scholar 

  8. Ebraheim N, Lu J. Morphometric evaluation of the sacral dorsal root ganglia: A cadaveric study. Surg Radiol Anat. 1998;20(2):105–8.

    CAS  PubMed  Google Scholar 

  9. Feler C, Whitworth L, Brookoff D, Powell R. Recent advances: sacral nerve root stimulation using a retrograde method of lead insertion for the treatment of pelvic pain due to interstitial cystitis. Neuromodulation. 1999;2(3):211–6.

    Article  CAS  Google Scholar 

  10. Gajewski J, Al-Zahrani A. The long-term efficacy of sacral neuromodulation in the management of intractable cases of bladder pain syndrome: 14 years of experience in one centre. BJU Int. 2010;107(8):1258–64.

    Article  Google Scholar 

  11. Hayek SM, Veizi E, Hanes M. Treatment-limiting complications of percutaneous spinal cord stimulator implants: a review of eight years of experience from an academic center database. Neuromodulation Technol Neural Interface. 2015;18(7):603–9.

    Article  Google Scholar 

  12. 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. 2012;13(1):3–17.

    Article  Google Scholar 

  13. Kapural L, Narouze S, Janicki T, Mekhail N. Spinal cord stimulation is an effective treatment for the chronic intractable visceral pelvic pain. Pain Med. 2006;7(5):440–3.

    Article  Google Scholar 

  14. 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. Neuromodulation Technol Neural Interface. 2006;9(3):229–33.

    Article  Google Scholar 

  15. Martellucci J, Naldini G, Carriero A. Sacral nerve modulation in the treatment of chronic pelvic pain. Int J Color Dis. 2011;27(7):921–6.

    Article  Google Scholar 

  16. McDonald JS, Alo KM. Bonica’s Management of Pain, 3rd Edition. In: Loeser J, editor. Section E: Pain in Pelvis, Perineum, and Genitalia: Chapter 73, Pain of Urogenital Origin. Philadelphia, PA: Lippinncott, Williams & Wilkins; 2001. p. 1448–61.

    Google Scholar 

  17. Nair A, Klapper A, Kushnerik V, Margulis I, Del Priore G. Spinal cord stimulator for the treatment of a woman with vulvovaginal burning and deep pelvic pain. Obstet Gynecol. 2008;111(2, Part 2):545–7.

    Article  Google Scholar 

  18. Paleček J. The role of dorsal columns pathway in visceral pain. Physiol Res. 2004;53(Supp. 1):S125–30.

    PubMed  Google Scholar 

  19. Role of lumbosacral retrograde neuromodulation in the treatment of painful disorders. Pain Physician. 2013;16(2):145–53.

    Google Scholar 

  20. Sakas D, Krames E, Simpson B. Operative neuromodulation. Vienna: Springer; 2007.

    Book  Google Scholar 

  21. Sator-Katzenschlager S, Scharbert G, Kress H, Frickey N, Ellend A, Gleiss A, et al. Chronic pelvic pain treated with gabapentin and amitriptyline: a randomized controlled pilot study. Wien Klin Wochenschr. 2005;117(21–22):761–8.

    Article  CAS  Google Scholar 

  22. Stones R, Selfe S, Fransman S, Horn S. Psychosocial and economic impact of chronic pelvic pain. Best Pract Res Clin Obstet Gynaecol. 2000;14(3):415–31.

    Article  CAS  Google Scholar 

  23. Stratton P, Khachikyan I, Sinaii N, Ortiz R, Shah J. Association of chronic pelvic pain and endometriosis with signs of sensitization and myofascial pain. Obstet Gynecol. 2015;125(3):719–28.

    Article  Google Scholar 

  24. Woolf CJ. Central sensitization: Implications for the diagnosis and treatmentof pain. Pain. 2011;152:S2–15.

    Article  Google Scholar 

  25. Yang C. Neuromodulation in male chronic pelvic pain syndrome: rationale and practice. World J Urol. 2013;31(4):767–72.

    Article  Google Scholar 

  26. Zuidema X, Breel J, Wille F. S3 dorsal root ganglion/nerve root stimulation for refractory postsurgical perineal pain: technical aspects of anchorless sacral transforaminal lead placement. Case Rep Neurol Med. 2016;2016:1–3.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Corey W. Hunter .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hunter, C.W., Patel, D. (2019). Percutaneous Sacral Nerve Stimulation. In: Deer, T., Pope, J., Lamer, T., Provenzano, D. (eds) Deer's Treatment of Pain. Springer, Cham. https://doi.org/10.1007/978-3-030-12281-2_72

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-12281-2_72

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-12280-5

  • Online ISBN: 978-3-030-12281-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics