open access

Vol 49, No 5 (2015)
Original research articles
Submitted: 2015-03-07
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Sacral roots stimulation in chronic pelvic pain

Paweł Sokal, Piotr Zieliński, Marek Harat
DOI: 10.1016/j.pjnns.2015.07.003
·
Neurol Neurochir Pol 2015;49(5):307-312.

open access

Vol 49, No 5 (2015)
Original research articles
Submitted: 2015-03-07

Abstract

Introduction

Chronic pelvic pain is a syndrome of chronic non-malignant pain of multifactorial pathophysiology. Perineal, anal and coccygeal pain can be a form of failed-back surgery syndrome or complex regional pain syndrome. Apart from conservative treatment interventional methods are useful in this condition as neurolytic blocks or non-destructive neuromodulation procedures. Peripheral nerve, spinal cord stimulation or sacral stimulation can be applied.

Aim

We describe a minimally invasive method of sacral roots stimulation with percutaneous electrodes implanted through the sacral hiatus in the treatment of chronic pelvic pain.

Materials and methods

We evaluated a series of nine female patients with pelvic pain treated with sacral roots stimulation in regard of efficacy and complications of this method.

Results

Short-term results in all patients were satisfactory with statistically significant improvement (median VAS=9 before surgery) (median VAS=2 after implantation, p=0.001), (median VAS=3 after 6 months, p=0.043). The long-term follow-up revealed less satisfactory result (median VAS=6 after 12 months). High incidence of complications was noted: mainly infection in 3/9 patients.

Conclusion

Sacral roots stimulation is a non-destructive and minimally invasive neuromodulation method in the treatment of chronic pelvic pain. It can be effective even in the long-term observation but special care is advised to secure aseptic conditions in the implantation and to prevent the infection which leads to removal of the stimulating system.

Abstract

Introduction

Chronic pelvic pain is a syndrome of chronic non-malignant pain of multifactorial pathophysiology. Perineal, anal and coccygeal pain can be a form of failed-back surgery syndrome or complex regional pain syndrome. Apart from conservative treatment interventional methods are useful in this condition as neurolytic blocks or non-destructive neuromodulation procedures. Peripheral nerve, spinal cord stimulation or sacral stimulation can be applied.

Aim

We describe a minimally invasive method of sacral roots stimulation with percutaneous electrodes implanted through the sacral hiatus in the treatment of chronic pelvic pain.

Materials and methods

We evaluated a series of nine female patients with pelvic pain treated with sacral roots stimulation in regard of efficacy and complications of this method.

Results

Short-term results in all patients were satisfactory with statistically significant improvement (median VAS=9 before surgery) (median VAS=2 after implantation, p=0.001), (median VAS=3 after 6 months, p=0.043). The long-term follow-up revealed less satisfactory result (median VAS=6 after 12 months). High incidence of complications was noted: mainly infection in 3/9 patients.

Conclusion

Sacral roots stimulation is a non-destructive and minimally invasive neuromodulation method in the treatment of chronic pelvic pain. It can be effective even in the long-term observation but special care is advised to secure aseptic conditions in the implantation and to prevent the infection which leads to removal of the stimulating system.

Get Citation

Keywords

Chronic pelvic pain, Sacral neuromodulation, Sacral roots stimulation, Failed back surgery syndrome, Complex regional pain syndrome

About this article
Title

Sacral roots stimulation in chronic pelvic pain

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 49, No 5 (2015)

Pages

307-312

DOI

10.1016/j.pjnns.2015.07.003

Bibliographic record

Neurol Neurochir Pol 2015;49(5):307-312.

Keywords

Chronic pelvic pain
Sacral neuromodulation
Sacral roots stimulation
Failed back surgery syndrome
Complex regional pain syndrome

Authors

Paweł Sokal
Piotr Zieliński
Marek Harat

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