Preliminary establishment of a novel localization method for sacral nerve foramen puncturing
10.3969/j.issn.1009-8291.2024.06.010
- VernacularTitle:一种新型骶神经孔穿刺定位方法的初步确立
- Author:
Lei XU
1
;
Fei DU
1
;
Wenfu WANG
1
;
Lipeng CHEN
1
;
Benkang SHI
1
;
Yan LI
1
Author Information
1. Department of Urology, Qilu Hospital of Shandong University, Ji’nan 250012, China
- Publication Type:Journal Article
- Keywords:
spinal cord injury;
tethered cord syndrome;
sacral nerve modulation;
surface projection;
inferior margin of articulatio sacroiliaca;
sacral neural foramen
- From:
Journal of Modern Urology
2024;29(6):521-526
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To establish a novel localization method for sacral nerve foramen puncture by analyzing the characteristic of sacral nerve foramen trying to help improve the success rate of sacral foramen puncture. 【Methods】 Clinical data and sacrococcyx CT and three-dimensional reconstruction imaging data of 158 patients who received sacral nerve modulation (SNM) during Jan.2019 and Aug.2022 in our hospital were retrospectively analyzed.The distance between inferior margin of articulatio sacroiliaca and the internal edge of the 3rd neural foramen (D1), and the distance between the internal edge of the 3rd neural foramen and sacral midline (D2) were measured, and the ratio of D1 and D2 was calculated for precise intraoperative positioning. The measurement data characteristic and puncture results were analyzed. 【Results】 A total of 89 males and 69 females were included, with an average age of (49.0±16.9) years.The average D1, D2, and D1/D2 were (29.6±4.9) mm, (13.8±3.2) mm, and (2.2±0.6), respectively.Female patients had greater D1 \[(30.7±5.5) mm vs.(28.7±4.2) mm, P=0.010\] and D1/D2 \[(2.4±0.7) vs.(2.1±0.5), P=0.001\] than male patients.Compared with adults, the adolescents had smaller D1 \[(29.8±4.7) mm vs.(25.7±5.4) mm, P=0.006\].After precise intraoperative positioning using this positioning method, 158 patients were successfully punctured, 152 (96.20%) had excellent intraoperative neural response, 2 (1.27%) had good response, and 4 (2.53%) had average response. 【Conclusion】 The surface projection of sacral nerve was approximately at the middle-inner 1/3 of the inferior margin of articulatio sacroiliaca to sacral midline.Through measuring distance from inferior margin of articulatio sacroiliacato sacral midline via X-ray, sacral nerve situation could be performed in surface, which might be a secure way to accessorily situate electrode implantation site for sacral neuromodulation.
