Dorsal Root Ganglion Spinal Cord Stimulation: A Novel Target in an Exciting Time in Neuromodulation

2016 ◽  
Author(s):  
Timothy R. Deer ◽  
Jason E. Pope ◽  
Eric T. Lee ◽  
Corey W. Hunter
Keyword(s):  
Spinal Cord ◽  
Dorsal Root Ganglion ◽  
Spinal Cord Stimulation ◽  
Dorsal Root ◽  
Pain Syndrome ◽  
Active Role ◽  
Posterior Aspect ◽  
Dorsal Columns ◽  
Exciting Time ◽  
Novel Target

The dorsal root ganglion (DRG) is a cluster of neurons located in the dorsal nerve root and is responsible for relaying sensory signals from the peripheral nervous system to the brain. Previously, the DRG was thought to be a purely supportive structure with no active role in chronic neuropathic pain; more recent evidence, however, suggests that the DRG is directly responsible for the development and even maintaining it. The concept of DRG stimulation is quite similar to traditional stimulation, with one very important difference: rather than placing leads over the posterior aspect of the cord to affect the dorsal columns, the leads are placed over the DRG(s), thus stimulating the cell bodies directly and modulating the pain at the source. Key words: causalgia, complex regional pain syndrome, dorsal root ganglion, neuromodulation, reflex sympathetic dystrophy, 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

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

Therapy Habituation at 12 Months: Spinal Cord Stimulation Versus Dorsal Root Ganglion Stimulation for Complex Regional Pain Syndrome Type I and II

2020 ◽  
Vol 21 (3-4) ◽  
pp. 399-408 ◽  
Author(s):  
Robert M. Levy ◽  
Nagy Mekhail ◽  
Jeffrey Kramer ◽  
Lawrence Poree ◽  
Kasra Amirdelfan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Dorsal Root Ganglion ◽  
Complex Regional Pain Syndrome ◽  
Spinal Cord Stimulation ◽  
Dorsal Root ◽  
Pain Syndrome ◽  
Type I ◽  
Syndrome Type

scholarly journals Comparison of Spinal Cord Stimulation vs. Dorsal Root Ganglion Stimulation vs. Association of Both in Patients with Refractory Chronic Back and/or Lower Limb Neuropathic Pain: An International, Prospective, Randomized, Double-Blinded, Crossover Trial (BOOST-DRG Study)

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 7
Author(s):  
Philippe Rigoard ◽  
Manuel Roulaud ◽  
Lisa Goudman ◽  
Nihel Adjali ◽  
Amine Ounajim ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Dorsal Root Ganglion ◽  
Spinal Cord Stimulation ◽  
Dorsal Root ◽  
Functional Disability ◽  
Pain Syndrome ◽  
Spinal Pain ◽  
Assess Quality ◽  
Global Impression Of Change ◽  
Double Blinded

While spinal cord stimulation (SCS) is a well-established therapy to address refractory persistent spinal pain syndrome after spinal surgery (PSPS-T2), its lack of spatial selectivity and reported discomfort due to positional effects can be considered as significant limitations. As alternatives, new waveforms, such as burst stimulation and different spatial neural targets, such as dorsal root ganglion stimulation (DRGS), have shown promising results. Comparisons between DRGS and standard SCS, or their combination, have never been studied on the same patients. “BOOST DRG” is the first prospective, randomized, double-blinded, crossover study to compare SCS vs. DRGS vs. SCS+DRGS. Sixty-six PSPS-T2 patients will be recruited internationally in three centers. Before crossing over, patients will receive each stimulation modality for 1 month, using tonic conventional stimulation. After 3 months, stimulation will consist in switching to burst for 1 month, and patients will choose which modality/waveform they receive and will then be reassessed at 6 and 12 months. In addition to our primary outcome based on pain rating, this study is designed to assess quality of life, functional disability, psychological distress, pain surface coverage, global impression of change, medication quantification, adverse events, brain functional imaging and electroencephalography, with the objective being to provide a multidimensional insight based on composite pain assessment.

Sign in / Sign up

Export Citation Format

Share Document