Sacral neuromodulation is a surgical treatment for voiding difficulties. We report the case of a patient affected by overflow urinary incontinence and reduced bladder sensation subsequent to decompression and stabilization of L2-S1, showing that sacral nerve stimulation can be used in patients with sacral anatomy distortion and metallic fixation system. In these cases, implant is feasible with fluoroscopic guidance and little changes of standard implantation procedure.