Spina bifida occulta as a relative contraindication for percutaneous retrograde lead insertion for sacral nerve root stimulation

L. Madison Michael, Louis A. Whitworth, Claudio A. Feler

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Percutaneous retrograde lead insertion for sacral nerve root stimulation is a newly described technique being applied to a variety of pain disorders. The success of the procedure rests in a defined epidural space such that there is unimpeded progression of the lead into the desired location. It is hypothesized that any condition that results in anatomic compromise of the epidural space would prevent the success of the procedure. Two patients with biopsy-proven interstitial cystitis and intractable pain were referred to the senior author for evaluation. Percutaneous retrograde lead insertion for sacral nerve root stimulation was performed on these patients in a standard fashion (1,2). Intraoperative fluoroscopy verified the diagnosis of spina bifida occulta. In one patient, implantation was completed percutaneously, but later two of the leads were found to have been placed intradurally. In another patient, repeated attempts at passing the epidural lead distal to the congenital defect were unsuccessful, and the percutaneous procedure was aborted. In conclusion, we have found that the diagnosis of spina bifida occulta, or any other condition in which the epidural space is anatomically disrupted, is a relative contraindication for this procedure. Preoperative roentograms of the lumbar spine may be helpful in avoiding technical difficulties due to this diagnosis.

Original languageEnglish (US)
Pages (from-to)38-40
Number of pages3
JournalNeuromodulation
Volume5
Issue number1
DOIs
StatePublished - Feb 16 2002

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Keywords

  • Epidural
  • Sacral nerve root stimulation
  • Spina bifida occulta

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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