Tunneling Spinal Cord Stimulation Systems



Fig. 11.1
The course of tunneling is planned based on landmarks and the best direction for placing the tunneling tool



A159084_2_En_11_Fig2_HTML.gif


Fig. 11.2
Local anesthesia placed along the tract for tunneling


A159084_2_En_11_Fig3_HTML.gif


Fig. 11.3
Initiation of tunneling at lead insertion site


A159084_2_En_11_Fig4_HTML.gif


Fig. 11.4
Angle of tunneling with attention to sterile technique


A159084_2_En_11_Fig5_HTML.gif


Fig. 11.5
Palpation of the course of tunneling to ensure adequate depth


A159084_2_En_11_Fig6_HTML.gif


Fig. 11.6
Continued progress of tunneling toward the pocket


A159084_2_En_11_Fig7_HTML.gif


Fig. 11.7
Final passing of the device through the tissue to complete the tunneling process


A159084_2_En_11_Fig8_HTML.gif


Fig. 11.8
Lateral decubitus representation of tunneling along a planned direction


A159084_2_En_11_Fig9_HTML.gif


Fig. 11.9
Depiction of tunneling from the posterior lead position to the generator pocket


A159084_2_En_11_Fig10_HTML.gif


Fig. 11.10
The completed tunneling procedure in lateral decubitus position




11.3 Risk Assessment




1.

The risk of tunneling depth should be considered. The physician may tunnel in a superficial plane, causing skin irritation or eventual erosion. The physician may tunnel too deeply, causing injury to muscle or more serious dilemmas such as visceral or pleural injury.

Only gold members can continue reading. Log In or Register to continue

Stay updated, free articles. Join our Telegram channel

Oct 16, 2016 | Posted by in PAIN MEDICINE | Comments Off on Tunneling Spinal Cord Stimulation Systems

Full access? Get Clinical Tree

Get Clinical Tree app for offline access