What is the main reason for ensuring leads are posterior when placed in the epidural space?

Ensuring that leads are positioned posteriorly when placed in the epidural space is important for a couple of key reasons. First, positioning the leads posteriorly helps to stimulate the correct nerve fibers. This is crucial for effective pain management and neurological responses, as the dorsal columns (which are responsible for touch and proprioception) are located in this area. Proper stimulation can result in a more efficient and targeted therapeutic outcome for the patient.

Secondly, placing the leads in a posterior position can help minimize discomfort associated with the leads. If the leads were placed inaccurately, such as anteriorly, patients could experience increased discomfort or even pain due to improper nerve stimulation or irritation.

The combination of these factors – effective nerve stimulation and reduced discomfort – underscores the importance of achieving the correct lead placement in the epidural space. This is why choosing both stimulating the correct nerve and avoiding discomfort as critical considerations for lead placement captures the rationale for ensuring posterior positioning.