Peripheral nerve stimulation: Lead position monitoring by reconstruction CT angiography-A technical report

Background: The authors investigated the possibility of improving positioning of stimulation leads in patients with chronic neuropathic peripheral nerve pain and good pain relief from implantation of a peripheral nerve stimulator (PNS). Methods: This pilot study includes four patients suffering from Chronic Regional Pain Syndrome type II (CRPS II) or neuropathic mononeuropathy treated with PNS therapy. The affected extremities and corresponding implantation sites were examined using computer tomographic scans (CT), additional CT angiography (CTA), reconstruction techniques and postprocessing procedures. Results: It was possible to prove a close relation between the implanted device and the neurovascular bundle in each of these cases. Thus, indirect lead position control was obtained. Conclusions: Computer tomographic techniques represent a reliable method for the position control of implanted peripheral nerve electrodes. Hence, this procedure should surpass general radiographies in detecting lead displacements.