The application value of H-reflex induced by electrical stimulation of the sacral nerve at the S3 foramen in stimulus parameter programming

Abstract

Although manufacturers of sacral nerve stimulators and related research have provided many guiding opinions on the programming values of stimulation parameters, the stimulation parameters used for long-term treatment of patients are still largely influenced by the experience of doctors and the subjective feelings of patients. We found a high positive correlation between the appearance and amplitude growth trend of the H-reflex induced by S3 nerve root stimulation, the stimulation amplitude corresponding to the inflection point, and the subjective sensation threshold and pain threshold of patients who underwent the first phase of implantable stimulatory surgery, through electromyography collection. Based on this, we believe that the information on the H-reflex triggered by S3 nerve root stimulation will provide a more intuitive and quantifiable non-invasive way for doctors to assist in determining the appropriate stimulator amplitude for long-term treatment of patients. This will help reduce unnecessary pain and potential permanent nerve damage risks that may occur to patients during parameter programming and debugging processes. Especially when facing patients with communication barriers or lack of cooperation, it is more meaningful.