scholarly journals Dorsal root ganglion stimulation combined with spinal cord stimulation for effective treatment of postherpetic neuralgia - A case report -

2021 ◽  
Author(s):  
Seung Wan Hong ◽  
Min Jung Kim ◽  
Cheol Hwan Park ◽  
Sarah Park ◽  
Jae Hun Kim
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Dorsal Root Ganglion ◽  
Effective Treatment ◽  
Treatment Option ◽  
Postherpetic Neuralgia ◽  
Spinal Cord Stimulation ◽  
Dorsal Root ◽  
Pain Site ◽  
Good Treatment Option

Background: Although spinal cord stimulation (SCS) can be a treatment option for intractable postherpetic neuralgia (PHN), obtaining proper stimulation at the thoracic dermatome is difficult. Dorsal root ganglion (DRG) stimulation may be an effective treatment for patients with insufficient efficacy in SCS only.Case: A 54-year-old man with intractable PHN was referred to our clinic. Pain was localized to the distribution of the T1–3 dermatomes. SCS trial was conducted, and lead was placed within the epidural space over the C6–T1 level; however, the stimulation was inadequate for his pain site. Therefore, another lead was placed within the left T1 and T2 DRG for trial, and T1 DRG stimulation provided adequate stimulation. T1 DRG stimulation and SCS could cover the entire pain site with paresthesia, and his pain was decreased by over 50%.Conclusions: DRG stimulation combined with SCS may be a good treatment option for intractable thoracic PHN.

scholarly journals Spinal Cord Stimulation as a Treatment Option for Refractory Chemotherapy-Induced Peripheral Neuropathy: Case Report

2020 ◽  
Vol 39 (03) ◽  
pp. 228-231 ◽  
Author(s):  
Arthur Lopes ◽  
Kleber Duarte ◽  
Catarina Lins ◽  
Gabriel Kubota ◽  
Valquíria Silva ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Spinal Cord ◽  
Neuropathic Pain ◽  
Case Report ◽  
Peripheral Neuropathy ◽  
Treatment Option ◽  
Spinal Cord Stimulation ◽  
Lower Limbs ◽  
Oncological Diseases ◽  
Good Treatment Option

AbstractColorectal cancer is one of the most common oncological diseases. Chemotherapy is usually recommended as an adjuvant treatment for stage-II, -III, and -IV tumors. Approximately 10% of the patients develop neuropathic pain after chemotherapy, and they may remain refractory despite the administration of drugs that are commonly used to treat neuropathic pain. Spinal cord stimulation is a good treatment option for neuropathic pain of the lower limbs, and it should be trialed in patients with chemotherapy-induced peripheral neuropathy. We report the case of a patient with oxaliplatin-induced neuropathy and neuropathic pain refractory to oral medication who was successfully treated by spinal cord stimulation.

scholarly journals Two Cases of Dorsal Root Ganglion Stimulation for the Treatment of Postherpetic Neuralgia

2020 ◽  
pp. 179-182
Author(s):  
Chong Kim
Keyword(s):  
Spinal Cord ◽  
Dorsal Root Ganglion ◽  
Postherpetic Neuralgia ◽  
Spinal Cord Stimulation ◽  
Dorsal Root ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Intractable Pain ◽  
Thoracic Level ◽  
Significant Burden

Background: Postherpetic neuralgia (PHN) is the most common long-term complication of shingles and is a significant burden to the patients due to pain and disability. Currently, treatment options are limited. In refractory cases, neuromodulation using spinal cord stimulation (SCS) and peripheral nerve stimulation (PNS) have been used but is considered experimental due to limited evidence. Dorsal root ganglion (DRG) stimulation has been most studied in complex regional pain syndrome and uses electrical leads that are inserted into the epidural space and placed into the intervertebral foramen to target the DRG. Due to the advantages on targeting the DRG, DRG stimulation has been used and can be considered to treat other refractory, intractable pain conditions. Case Report: We report 2 cases who experienced successful treatment of refractory PHN. Patients underwent dorsal root ganglion stimulation at the thoracic level for the treatment of refractory PHN. Both patients showed significant improvement in pain at 24 and 36 months after a DRG stimulation trial and implantation. Conclusion: We report the successful use of DRG stimulation for the treatment of PHN. Key words: Dorsal root ganglion stimulation, neuralgia, neuromodulation, postherpetic neuralgia, spinal cord stimulation

Dorsal root ganglion stimulation lead fractures: potential mechanisms and ways to avoid

2021 ◽  
Vol 14 (5) ◽  
pp. e241353
Author(s):  
Gaurav Chauhan ◽  
Brandon I Roth ◽  
Nagy Mekhail
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Case Report ◽  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Unusual Case ◽  
Pain Syndrome ◽  
Structural Instability ◽  
Probable Mechanism ◽  
Lead Fracture

Dorsal root ganglion stimulation (DRGS) therapy is a rapidly emerging tool being used by pain physicians in the treatment of chronic pain. Complex regional pain syndrome (CRPS), a debilitating disease whose mechanism is still has yet to be fully elucidated, is a common pathology targeted by DRGS therapy, often better results than traditional spinal cord stimulation. DRGS therapy, however, is not bereft of complications. Lead migration and fracture are two examples in particular that are among the most common of these complications. The authors report an unusual case of lost efficacy due to lead fractures in patients with CRPS treated with DRGS. The case report narrates identification, management and probable mechanism of DRGS lead fracture. The structural instability of DRGS leads can yield distressing symptoms at any point during the therapy, and physicians should be cognisant of the complications of DRGS therapy.

Changes in Dorsal Root Ganglion Gene Expression in Response to Spinal Cord Stimulation

2017 ◽  
Vol 42 (2) ◽  
pp. 246-251 ◽  
Author(s):  
Dana M. Tilley ◽  
David L. Cedeño ◽  
Courtney A. Kelley ◽  
Margaret DeMaegd ◽  
Ramsin Benyamin ◽  
...  
Keyword(s):  
Gene Expression ◽  
Spinal Cord ◽  
Dorsal Root Ganglion ◽  
Spinal Cord Stimulation ◽  
Dorsal Root

scholarly journals Comparison of FDA-Approved Electrical Neuromodulation Techniques for Focal Neuropathic Pain: A Narrative Review of DRG, HF10, and Burst Neuromodulation

2021 ◽  
pp. E407-E423
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Dorsal Root Ganglion ◽  
Spinal Cord Stimulation ◽  
High Frequency ◽  
Dorsal Root ◽  
Case Reports ◽  
Case Series ◽  
Dorsal Column ◽  
Small Sample

BACKGROUND: Evidence suggests that dorsal root ganglion stimulation (DRGS) is a more effective treatment for focal neuropathic pain (FNP) compared with tonic, paresthesia-based dorsal column spinal cord stimulation (SCS). However, new advancements in waveforms for dorsal column SCS have not been thoroughly studied or compared with DRGS for the treatment of FNP. OBJECTIVES: The purpose of this review was to examine the evidence for these novel technologies; to highlight the lack of high-quality evidence for the use of neuromodulation to treat FNP syndromes other than complex regional pain syndrome I or II of the lower extremity; to emphasize the absence of comparison studies between DRGS, burst SCS, and high-frequency SCS; and to underscore that consideration of all neuromodulation systems is more patient-centric than a one-size-fits-all approach. STUDY DESIGN: This is a review article summarizing case reports, case series, retrospective studies, prospective studies, and review articles. SETTING: The University of Miami, Florida. METHODS: A literature search was conducted from February to March 2020 using the PubMed and EMBASE databases and keywords related to DRGS, burst SCS, HF10 (high-frequency of 10 kHz), and FNP syndromes. All English-based literature from 2010 reporting clinical data in human patients were included. RESULTS: Data for the treatment of FNP using burst SCS and HF10 SCS are limited (n = 11 for burst SCS and n = 11 for HF10 SCS). The majority of these studies were small, single-center, nonrandomized, noncontrolled, retrospective case series and case reports with short follow-up duration. To date, there are only 2 randomized controlled trials for burst and HF10 for the treatment of FNP. LIMITATIONS: No studies were available comparing DRGS to HF10 or burst for the treatment of FNP. Data for the treatment of FNP using HF10 and burst stimulation were limited to a small sample size reported in mostly case reports and case series. CONCLUSIONS: FNP is a complex disease, and familiarity with all available systems allows the greatest chance of success. KEY WORDS: Dorsal root ganglion, high frequency, burst, spinal cord stimulation, neuromodulation, focal neuropathic pain

scholarly journals Dorsal root ganglion stimulation for treatment of complex regional pain syndrome of the foot

2020 ◽  
Vol 3 (2) ◽  
pp. V8
Author(s):  
Kevin Hines ◽  
Fadi Al Saiegh ◽  
Aria Mahtabfar ◽  
Kavantissa M. Keppetipola ◽  
Caio M. Matias ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Dorsal Root Ganglion ◽  
Complex Regional Pain Syndrome ◽  
Spinal Cord Stimulation ◽  
Dorsal Root ◽  
Pain Syndrome ◽  
Thoracic Spinal Cord ◽  
Plantar Aspect ◽  
Thoracic Spinal ◽  
The Right

This is a case of a 54-year-old man presenting with complex regional pain syndrome (CRPS) type 1 of the right lower extremity, which was most debilitating in the plantar aspect of the right foot. The patient had prior treatment with thoracic spinal cord stimulation; however, the foot pain remained intractable. Given that his pain was predominantly in his foot and remained debilitating despite thoracic spinal cord stimulation, it was recommended that the patient undergo a trial of dorsal root ganglion (DRG) stimulation. The surgical technique for placement of dorsal root ganglion stimulators is demonstrated in this operative video.The video can be found here: https://youtu.be/_1xMxFZa6tU

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