• Kenneth B Chapman, Noud van Helmond, Jan Willem Kallewaard, Kris C Vissers, Kiran V Patel, Soriaya Motivala, Jonathan M Hagedorn, Timothy R Deer, and David M Dickerson.
• The Spine & Pain Institute of New York, New York, New York, USA.
• Pain Med. 2022 Sep 30; 23 (10): 175017561750-1756.

ObjectiveA heightened and organized understanding of sacral anatomy could potentially lead to a more effective and safe method of dorsal root ganglion stimulation (DRG-S) lead placement. The aim of this technical note is to describe a standardized access method for S1 DRG-S lead placement.DesignTechnical note.MethodsThe described approach utilizes alignment of the lumbosacral prominence and is measurement-based, allowing for standardized sacral access, even when visualization is suboptimal. The medial-to-lateral needle trajectory is designed to limit interaction with the sensitive neural structures and allows for a more parallel orientation of the lead to the DRG and nerve root.ConclusionsThe described technique potentially improves the safety of S1 DRG-S lead placement. The parallel lead orientation to the DRG may also increase efficacy while lowering energy requirements.© The Author(s) 2022. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.

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