Development of a CT-guided standard approach for tined lead implantation at the sacral nerve root S3 in minipigs for chronic neuromodulation

Research and Reports in Urology, 2016 · DOI: http://dx.doi.org/10.2147/RRU.S115181 · Published: September 28, 2016

Urology Neurology Research Methodology & Design

Simple Explanation

This study introduces a new method for implanting electrodes for sacral neuromodulation (SNM) using CT guidance in minipigs. The technique aims to improve the precision of nerve targeting and electrode placement compared to traditional methods. The procedure involves using CT scans to visualize the anatomy and guide the placement of tined leads near the sacral nerve root S3.

Study Duration

3.5 Months

Participants

Five female Göttingen minipigs

Evidence Level

Not specified

Key Findings

1
Successful bilateral tined lead implantation was achieved in four out of five minipigs using the CT-guided technique.
2
Intraoperative stimulation resulted in observable responses such as twitching of the perianal muscles and tail rotation, confirming correct lead placement.
3
Follow-up CT scans after 3.5 months showed that the leads remained in the correct position without migration.

Research Summary

The study successfully developed a CT-guided technique for tined lead implantation in minipigs for sacral neuromodulation. The procedure allows for precise targeting of the sacral nerve root S3, leading to predictable functional outcomes. The authors conclude that this standardized protocol can be used for future chronic stimulation studies in minipigs.

Practical Implications

Improved SNM Techniques

The CT-guided approach may offer more precise and reliable electrode placement for SNM, potentially improving treatment outcomes.

Animal Model for SNM Research

The developed technique provides a controlled and standardized method for chronic SNM studies in minipigs, which can be used to evaluate new therapies.

Translation to Clinical Practice

The use of standard clinical equipment and well-defined functional outcomes facilitates the translation of findings from animal studies to human applications.

Study Limitations

1
The puncture had to be performed from the contralateral side due to the small size of the minipigs' neuroforamina.
2
The sheath did not always pass smoothly through the neuroforamen due to the size mismatch between the instruments and the animal anatomy.
3
One tined lead failed to be properly fixed due to inappropriate length and insertion depth relative to S3.

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