Sacral Nerve Stimulation With Percutaneous Dorsal Transforamenal Approach in Treatment of Isolated Pelvic Pain Syndromes

Authors


Address correspondence and reprint requests to: Angelo Lavano, PhD, Department of Neurosurgery, Policlinico MaterDomini, Viale Tommaso Campanella 115, 88100 Catanzaro, ITALY. Email: lavano@uniz.it or anlavano@tin.it

Abstract

Objectives.  The aim of the study was to test the effectiveness of sacral nerve stimulation (SNS) performed by a transforamenal approach in patients with isolated chronic intractable pelvic pain.

Materials.  Sevenpatients with intractable pelvic pain underwent implantation of self-anchoring leads by way of the dorsal S3 foramen in four cases and of the dorsal S4 foramen in three cases. Patients with pain improvement > 50% underwent sacral nerve root stimulation device implantation. SNS therapeutic efficacy was measured using a visual analog scale (VAS) and its effects on quality of life (QoL) using the SF-36 scale.

Results.  During test stimulation five patients had significant and permanent pain relief and subsequently underwent implantation of a permanent device. VAS score improvement was evident in these patients and remained unchanged at 3, 6, and 12 months (median 8 months); SF-36 QoL questionnaire also revealed significant improvement in many domains of QoL including all the four physical domains and three of the four mental domains. There were three complications in our seven patients: one lead fracture, one lead displacement in the presacral space, and one patient who developed pain at the implantable pulse generator site.

Conclusions.  Transforamenal SNS is effective in relieving isolated pelvic pain but a high complication rate was found.

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