Peripheral Nerve Stimulation for Chronic Shoulder Pain: A Proof of Concept Anatomy Study

Neuromodulation. 2018 Apr;21(3):284-289. doi: 10.1111/ner.12749. Epub 2018 Jan 3.

Abstract

Objectives: Although spinal cord and dorsal root ganglia stimulation may be effective for managing regional pain syndromes, a more targeted approach is perhaps more appealing for discrete anatomical structures. Chronic shoulder pain is a common musculoskeletal problem with significant socioeconomic impact. A peripheral nerve stimulation of the axillary and suprascapular nerves may prove to be effective as a long-term solution for this indication. In anticipation of the future experimental research and clinical utilization, a sound methodology for the lead placement was developed, and its feasibility is tested in a cadaveric study.

Materials and methods: Normal anatomy was corroborated with ultrasound scans of live models and cadaver specimens. A step-by-step ultrasound-guided implantation technique was designed. The procedure was completed targeting both the axillary and suprascapular nerves. The accuracy of the lead placement was confirmed by dissections.

Results: The implanted devices were found adjacent to the target nerves within 0.5-1 cm distance.

Conclusions: The anatomical dissections confirmed the accuracy of ultrasound-guided placement of the lead. The described method is based on normal anatomy and appeared to be reproducible by following the outlined procedural steps.

Keywords: Anatomy; implantation; peripheral nerve stimulation; shoulder pain; technical report.

Publication types

  • Review

MeSH terms

  • Cadaver
  • Chronic Pain / therapy
  • Electric Stimulation Therapy / methods*
  • Humans
  • Models, Anatomic
  • Pain Management / methods*
  • Proof of Concept Study*
  • Shoulder / innervation*
  • Shoulder Pain / therapy