Computer-assisted lead placement for peripheral nerve evaluation test in a candidate for sacral neuromodulation

Abstract

Our aim was to report the first case of computer-assisted lead placement (CALP) for a peripheral nerve evaluation (PNE) test in a 55-year-old woman affected by chronic pelvic pain, who was a candidate for sacral neuromodulation (SNM). The first PNE test failed due to nonoptimal lead placement. We utilized a surgical navigation system (SNS) with electromagnetic tracking to guide the lead placement to the S3 right nerve roots. Neither intra- nor postoperative complications occurred. After 2 weeks, the patient reported > 50% symptom improvement, so she was recommended to receive a definitive SNM implant. Our case report demonstrated the feasibility and safety of CALP for the PNE test. Since the use of an SNS may guide easy and precise lead placement along the S3 afferent nerve roots, further studies are mandatory to outline the advantages and limits of this innovative technique.