Sacral Nerve Stimulation Lead Migration through the Sciatic Foramen, Successfully Repositioned

Garazi Elorza-Echaniz, Garazi Elorza-Echaniz, Nerea Borda-Arrizabalaga,Ignacio Aguirre‐Allende, Yolanda Saralegui-Ansorena, Carlos Placer–Galán, José María Enríquez-Navascués

Surgical Case Reports(2021)

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摘要
Introduction: SNS (Sacral Nerve Stimulation) has become an established minimally invasive procedure for urinary and faecal incontinence. Minor complications related to the procedure are common; include pain, infection or migration. We present a case of a tined lead migration through the sciatic foramen. Case Report: A 72-year-old woman with faecal incontinence, who did not respond to dietary of medical treatment, underwent a sacral nerve stimulation test. Under fluoroscopic vision a tined lead was placed in S3 foramen, with an adequate motor and sensory response. In the 7th postoperative day, she reported no improvement and she referred sensory response in the thigh and leg. Radiography showed migration of the electrode through the sciatic foramen. The repositioning of the same electrode was possible with a gentle traction of the lead. Correct placement of the lead was confirmed radiologically, and the patient showed motor and sensory response in the anal area. The patient improved Wexner score from 18/20 to 4/20. Conclusion: Migration of the tined lead should be considered if loss of response in found. Repositioning of the same lead is possible in selected patients, without the need of removal of the device.
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关键词
sciatic foramen,nerve,stimulation,migration
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