TY  - CHAP
M1  - Book, Section
TI  - Anterograde Versus Retrograde Lead Placement
A1  - Bedder, Marshall D.
A2  - Diwan, Sudhir
A2  - Staats, Peter S.
PY  - 2015
T2  - Atlas of Pain Medicine Procedures
AB  - The  discussion  for  an  anterograde  approach  versus  a  retrograde  approach  to  lead  placement  for  spinal  cord  stimulation  (SCS)  has  evolved  in  relationship  to  optimal  coverage  for  pelvic  pain  conditions.  Early  attempts  to  treat  bladder  pain  focused  on  retrograde  placement  of  SCS  leads  to  the  S3  foramen.  Unfamiliarity  of  many  practitioners  with  this  technique,  the  more  difficult  technical  aspects,  and  the  variable  anatomy  of  the  sacrum  have  all  posed  challenges  to  this  approach.  Anterograde  placement  with  lead  positioning  at  the  T10-T12  levels  has  shown  great  promise  in  pelvic  pain  structure  coverage.  It  is  now  known  that  retrograde  placement  is  actually  a  peripheral  nerve  stimulation  performed  within  the  spinal  canal  by  stimulating  specific  sacral  nerves.  Whereas  anterograde  placement  is  true  spinal  cord  stimulation  giving  rise  to  stimulation  paresthesia  not  only  in  the  pelvic  distribution  but  also  in  the  lower  extremities.  Anterograde  stimulation  produces  an  electrical  field  at  the  spinal  cord  activating  all  known  mechanisms  of  action,  whereas  it  is  highly  unlikely  that  peripheral  nerve  stimulation  activates  as  many  different  mechanisms  of  action.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=1107200397
ER  -