Figure 9.

Outside in approach: (A) Far oblique view with Tuohy needle making contact with the SAP. (B) AP view with Tuohy needle contacting SAP. (C) Tuohy needle retracted slightly with introducer and lead loaded and directed ventrally to the foramen. (D) Lead advanced alone into. (E) Lead advanced and Tuohy retracted slightly. (F) Loops made in soft tissue by advancing the introducer slightly and advancing lead. Then rotating introducer caudally and repeating. (G and H) Final AP and lateral views of lead position. Reproduced with permission from Chapman KB, Nagrani S, Patel KV, Yousef T, van Helmond N. Lumbar dorsal root ganglion stimulation lead placement using an outside-in technique in 4 patients with failed back surgery syndrome: a case series. A&A Pract. 2020;14(10):e01300.180. Available from: https://journals.lww.com/aacr/Abstract/2020/08000/Lumbar_Dorsal_Root_Ganglion_Stimulation_Lead.14.aspx.¹⁸⁰