E-Posters-10238

10238_Husk

Pdf Summary

Sacral neuromodulation (SNS) is a treatment where a lead is placed to stimulate the S3 foramen. However, there is limited data on the variations in sacral anatomy and lead location, as well as their impact on the success of SNS. Therefore, the objective of this study was to assess the predictors of success with SNS and to evaluate the variations in sacral anatomy.<br /><br />The study was conducted as a retrospective cohort study of individuals who underwent lead insertion for SNS between October 2008 and December 2016. The cohorts were divided based on the response to SNS, with success defined as more than 50% symptomatic improvement after stage I and continued clinical response. The sacral bony anatomy and lead location were assessed using intraoperative lateral and PA fluoroscopic images.<br /><br />The results showed that variations in sacral bony anatomy and lead placement were not associated with the success of SNS. However, it was found that the mean distance from the tip of the coccyx to S3 was 7 cm, not 9 cm as recommended in the "9 and 2 protocol." The mean distance from the midline sacrum to S3 was 2 cm. These findings suggest that marking bony landmarks prior to fluoroscopic images may be unnecessary.<br /><br />The primary outcome of the study was that sacral bony anatomical measurements were not associated with success. However, a straight lead placement was found to predict success. Other components of lead location and orientation did not impact the success of SNS.<br /><br />In conclusion, this study found that variations in sacral anatomy and lead location did not impact the success of SNS. The findings also suggest that the "9 and 2 protocol" may not be accurate in locating the S3 foramen. Further research is needed to better understand the predictors of success with SNS and to optimize lead placement.

Keywords

Sacral neuromodulation

SNS

lead placement

sacral anatomy

success predictors

retrospective cohort study

symptomatic improvement

fluoroscopic images

bony landmarks

lead location