Neuromodulation: Prospective analysis of intraoperative nerve monitoring and positioning S1 dorsal root ganglion to determine ideal lead positioning and predict postoperative planning

The dorsal root ganglion (DRG) is the relay or connection between the peripheral nerve and the central nervous system
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It has been shown to play a role in chronic neuropathic pain and is therefore suitable for the ideal structure of neuromodulation

Considering the changes in DRG position and the need to pass the electrodes through the spinal canal and foramen, it is a challenge to ideally place the electrodes through the transforaminal approach
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It also raises the need to map the DRG position correctly to ensure proper stimulus coverage

Nerve stimulation electrode

This is a prospective analysis that analyzes the application of intraoperative neuromonitoring (IONM) in sleeping patients, using somatosensory evoked potentials (SSEP) and electromyography (EMG) thresholds to map the location of S1 DRG, and It was compared with postoperative programming

12 lead placements were performed in 8 patients
.
Among them, there were 7 females and 1 male, aged 31-78 years old

DRG stimulation has proven effective in the treatment of focal pain, chronic neuropathic pain, peripheral neuropathy and CRPS
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The position of DRG in the cervical, thoracic, and lumbar regions is well described anatomically, and the position is repeatable, only lower than the pedicle (17, 10)

This forward-looking analysis further proves the practicability and accuracy of IONM
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The application of DRG-IONM is meaningful for determining the position and positioning of the dorsal root along the S1 dorsal root and guiding postoperative programming