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The posterior shin nerve (PTN) is responsible for the movement of the lower extremities such as the hips, knees and ankles. The sciatic nerve, consisting of the fibres L4 and S3, descends to the lower extremity and affects the anterior plexus, the sacral nerve in the pelvis and pelvic floor. The TIBIAL nerve runs along the leg, while the sacral nerve controls the function of the bladder, pelvis and floor. PTSD is a minimally invasive neuromodulation system that provides retrograde electrical stimulation to both the posterior and anterior tiberial nerves through the spinal cord and spinal canal (Figure 1). 

A fine needle electrode is inserted into the medial malleolus cephalad to stimulate the tibial nerve. Needle and electrode are inserted into the lateral plexus of the posterior titer nerves and the anterior cEPHALAD medial maltoleus. Fine needle electrodes are inserted into the nerves of the spinal cord as well as into the abdominal cavity of the pelvis and into a medial pelus and cephalus medialis malleolus and send stimulation through the TIBIAL nerve.

The treatment is performed by a thin needle placed in the ankle, where the shin nerve is located, and a surface electrode under the metatarsal. The treatment is performed with a fine needle electrode, which is inserted into the anterior cEPHALAD medial Maltoleus and Cephalad medialis malleolus. The needle and electrode are inserted through the skin into a posterior medial mallelus, which is advanced in the nerve tIBIALLY, and the treatment with the fine needles and electrodes sends stimulation through it. 

During the therapy you will feel a slight pulsation on both sides of the stimulation. This sensation is described by many as pulsating or tingling in the ankle or foot, suggesting that the shin nerve has been stimulated properly. 

You can visualize the somatosensory evoked potential (sep), which is measured as the number of pulses per second (pps) in the spinal cord (sps). This seems to be a good measure of the amount of stimulation and the degree of sensitivity to stimulation. 

Today, SNS is an evidence-based clinical tool, with patients given a fixed schedule followed by a personalized treatment plan aimed at maintaining the symptoms of OAB. PTSD treatments are performed based on the patient’s symptom report, and patients know that PTSD sessions are available for their needs when their symptoms increase. After the introduction of S NS, the next goal is to develop a long-term, consistent and effective treatment strategy for patients with spinal cord injuries.


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