Physician-Guided Lead Placement: Driving the Lead to the Target Location

Abstract

The placement of spinal cord stimulation (SCS) systems has several important components. For tonic stimulation requiring therapeutic paresthesia overlying the patient’s pain, placement of the device within the epidural space is paramount. Lead placement is important because the ability to delivery energy in the correct location and the flexibility to change the array of stimulation are dependent on the lead location. In the past few are shared in this chapter. In successfully placing leads the physician must choose a patient with acceptable anatomy for placement, properly insert a needle, and pick a target for the desired lead location for proper stimulation. In many patients the most difficult component of the procedure is guiding the lead from the needle to the end location. Multiple factors will influence the ease in which this task is completed. By modifying the technique, the physician can maximize the ease in which the lead is guided to the target.