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Aim Sacral nerve stimulation (SNS) lead implantation is a straightforward procedure for individuals with intact spinal vertebrae. When sacral anomalies are present, however, the anatomical and radiological reference points used for the accurate placement of the electrode may be absent or difficult to identify. Method We describe an innovative surgical procedure of percutaneous nerve evaluation for SNS in a patient with faecal incontinence secondary to a congenital imperforate anus and partial sacral agenesis using a surgical imaging platform (O-arm system) under neurophysiological control. Results Using intra-operative CT and neuronavigation, the insertion point at the skin was identified. The lead was introduced into the right-sided S3 foramen and placed at the correct depth. An appropriate motor response was obtained after stimulation and neurophysiological control confirmed that the right S3 root was being stimulated. Conclusion Our experience showed that O-arm guided navigation can be used to overcome the difficulty of SNS lead placement in patients with partial sacral agenesis who have faecal incontinence. [ABSTRACT FROM AUTHOR]

In the course of the seventeenth and eighteenth centuries, composers and music theorists moved away from the system of the eight ecclesiastical modes that had been elaborated by medieval theorists and was later applied to polyphonic music (including the varied system extended to twelve modes in the sixteenth century) towards modern bimodal tonality. Although several modal systems coexisted within this time period, a distinct variant of the eight modes, often known in modern scholarship as the church keys, developed as a practical solution to problems associated with the performance of psalms and other recited formulas (especially the Magnificat) in alternatim practice between the choir in plainchant and the organ. A scarcity of research on this topic within investigations of Spanish music prompts us to outline an introduction to a matter so crucial to music theory of the baroque period in Spain. Thus we present an overview of the treatment of the church keys or tones in Spanish treatises over a long period of two centuries, and focus briefly on particular contributions made by individual authors. [ABSTRACT FROM AUTHOR]

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