Review of ultrasound-guided peripheral nerve stimulation

Peripheral nerve stimulation has been performed for over four decades, but until recently, no minimally invasive technique has existed. A recently described percutaneous ultrasound (US)-guided needle and electrode placement may allow for improvement in patient selection and optimization of the technique. The literature on peripheral nerve stimulation and minimally invasive techniques was reviewed using MEDLINE. Anatomical landmarks and potential technical limitations were also reviewed. Review of two anatomical feasibility studies, the original cases series, anatomy texts, and other literature suggest that the potential application of US-guided placement of peripheral nerve stimulation systems is feasible. Application of these techniques will, however, require a significant concentrated experience in US evaluation, cross-sectional anatomy, and nerve block technique before attempting. There is minimal literature at present to suggest that peripheral nerve stimulation systems should be placed using US or other minimally invasive image-guided techniques. As an emerging technique, significant further research will be required to guide future use.