Selective Nerve Root Stimulation: Facilitating the Cephalocaudal “Retrograde” Method of Electrode Insertion

摘要: Selective nerve root stimulation (SNRS) as a method was first presented in 1998 and published 1999. Despite advances at that time dual electrode technology patient controlled programming, “anterograde” spinal cord stimulators (SCSs) were unable to consistently produce maintain paresthesia the neck, pelvic, foot dermatomes. As well some individual lower extremity dermatomes lacked SCS coverage. Thus, selective, cephalocaudal, “retrograde” placement developed improve capture these targets. Safety concerns limited cervical vivo application; however, lumbosacral gained interest evaluation of many difficult-to-treat conditions. initial enthusiasm success, encountered technical difficulty entering lumbar intralaminar space from superior inferior or direction. Subsequently this author began teaching needle entry technique utilizing lateral approach (Figs. 18.1, 18.2, 18.3, 18.4, 18.5, 18.6, 18.7, 18.8, 18.9, 18.10). This mimics “single-shot epidural” applied commonly by interventional practitioners. facilitates into epidural midline, standardizes below conus L2–3.