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Chronic headaches are the second most prevalent disease and second most common cause for years lived with disability worldwide Occipital neuralgia can cause headaches or be present in addition to other more prevalent causes of headache If these headaches fail to respond to conservative and pharmacological therapy physicians proceed to more invasive treatments starting with infiltration of the greater occipital nerve with local anesthetic with or without corticosteroids followed by nerve ablation or stimulation Occipital nerve stimulation gained more popularity as the technology improved and more pain physicians received training on interventional procedures In this manuscript we are presenting our experience with ultrasoundguided implant of occipital nerve stimulators using peripheral nerve stimulator systems After confirming appropriateness of treatment by a successful occipital nerve block ie resulting in 50 relief in patients pain intensity we implanted five stimulator systems in three patients two bilateral We followed these patients for an average of eight months and the average pain reduction was 50 We did not observe any adverse events during or immediately after surgery One patient developed an adverse reaction to the adhesive of the battery transmitter but it was not severe enough to stop her from using the stimulator Considering the ease of implant and minimal side effects implant of peripheral nerve stimulators to stimulate the occipital nerve is a promising treatment modality for patients with chronic headache who present with features of occipital neuralgia However wider use of this treatment modality is subject to further studies Considering the ease of implant and minimal side effects implant of peripheral nerve stimulators to stimulate the occipital nerve is a promising treatment modality for patients with chronic headache who present with features of occipital neuralgia However wider use of this treatment modality is subject to further studies This study aimed to describe and validate a novel ultrasoundguided intercostal peripheral nerve stimulator implantation technique The fifth to tenth ribs on both sides of an unembalmed cadaveric specimen were localized using a 156MHz linear array transducer counting distally from T1 bilaterally THZ1 A single interventionist then implanted 12 peripheral nerve stimulators on the fifth through tenth ribs six MicroLeads on the left side and six StimRouters on the right side using an inplane lateral to medial approach to the inferior border of the corresponding rib After all the stimulators were implanted their location was confirmed using fluoroscopy Gross anatomic dissection was later performed for each of the stimulators placed and the distance of the lead from the intercostal nerve and pleura was noted All leads were noted in an accurate position in the plane between the inner and innermost intercostal muscle without any intrapleural placement The distance of the leads from the intercostal nefor intercostal peripheral nerve stimulator implantation appears feasible and warrants further investigation to establish this as an acceptable technique for patients Peripheral nerve stimulation provides targeted stimulation and pain relief within a specific nerve distribution This technical case report provides a method to perform selective nerve root stimulation of thoracic and lumbar spinal nerves using ultrasonography Ultrasoundguided peripheral nerve stimulation of thoracic and lumbar spinal nerves allows better visualization of soft tissue anatomy and planning of needle trajectory Ultrasoundguided peripheral nerve stimulation procedures may provide a safer method for neurostimulation lead placement when compared with fluoroscopicguided techniques Ultrasoundguided peripheral nerve stimulation procedures may provide a safer method for neurostimulation lead placement when compared with fluoroscopicguided techniques Pudendal neuropathy is a chronic disabling form of perineal pain that involves the pudendal nerve a mixed somatic and autonomic nerve that originates from sacral nerve roots Peripheral nerve stimulation of the pudendal nerve can be useful to decrease symptom burden in patients who have failed initial conservative treatment modalities In this manuscript we describe an approach to the placement of a peripheral nerve stimulator for the treatment of pudendal neuralgia We present a case of complex pelvic neuropathy and review the factors that lead to successful placement Technical aspects of stimulator placement and ultrasound landmarks are reviewed A lateral to medial approach with ultrasound guidance at the level of the ischial spine is likely to facilitate proper lead placement along the course of the pudendal nerve Aftercare and adherence to postimplant activity restrictionsparticularly avoiding use of the extremes of hip flexion and extension for four weekslead to the absence of lead migration Pudendal nerve stimulation is an emerging technique for neuromodulation of refractory pudendal neuralgia Ultrasoundguided pudendal nerve stimulation is a viable technique for neuromodulation of pudendal neuralgia Optimization of patient selection ultrasound guidance and proper adherence to postimplant activity restrictions may be helpful for longterm therapeutic success Pudendal nerve stimulation is an emerging technique for neuromodulation of refractory pudendal neuralgia Ultrasoundguided pudendal nerve stimulation is a viable technique for neuromodulation of pudendal neuralgia Optimization of patient selection ultrasound guidance and proper adherence to postimplant activity restrictions may be helpful for longterm therapeutic success With advances in peripheral nerve stimulation technology there has been an emergence of new minimally invasive techniques to provide neurostimulation therapies for chronic pain This technical note describes the utilization of ultrasonography for percutaneous placement of peripheral nerve stimulation leads at the sciatic femoral and lateral femoral cutaneous nerves Ultrasound can be utilized to localize a specific nerve view neighboring soft tissue anatomy and plan a needle trajectory Various ultrasound techniques and transducer orientations allow for multiple options for lead placement relative to the targeted nerve The option of ultrasoundguided percutaneous technique for neurostimulation lead placement allows this treatment modality to be made available to more patients with chronic pain in specific nerve distributions The option of ultrasoundguided percutaneous technique for neurostimulation lead placement allows this treatment modality to be made available to more patients with chronic pain in specific nerve distributions