Complications and Effects of Dorsal Root Ganglion Stimulation in the Treatment of Chronic Neuropathic Pain: A Nationwide Cohort Study in Denmark

Horan, Mattias; Jacobsen, Anne; Ståhl, Christian; Rosenlund, Christina; Gulisano, Helga Angela; Søe, Morten; Sørensen, Jens Christian; Meier, Kaare; Blichfeldt-Eckhardt, Morten Rune

doi:10.1111/ner.13171

Cited by 31 publications

(30 citation statements)

References 34 publications

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“…14 Unfortunately, recent studies found higher than expected DRG-S lead migration and fracture incidences. 17,18 Lead migration can have significant consequences. The small size of the target DRG, combined with only 4 contacts per lead, means that even slight migration can result in loss of efficacy.…”

Section: Introductionmentioning

confidence: 99%

Lead migration and fracture rate in dorsal root ganglion stimulation using anchoring and non‐anchoring techniques: A multicenter pooled data analysis

et al. 2021

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Introduction: Dorsal root ganglion stimulation (DRG-S) is a neuromodulation technique introduced in the last decade with evolving implant methods. Initial prospective research found low incidences of lead migration and lead fracture with DRG-S. However, several recent studies have highlighted high lead migration and lead fracture rates with DRG-S. We investigated the influence of lead anchoring on migrations and fractures. Methods:We performed a retrospective review between 2016 and 2020 of individuals implanted with DRG-S leads by 4 experienced implanters. The implanters independently changed their standard practice regarding lead anchoring over time, with opposing trends (no anchoring > anchoring, anchoring > no anchoring). We compared lead migration and lead fracture rates between anchored and unanchored DRG-S leads in the entire study cohort. Cox regression was performed on lead migration and fracture distributions. Results:We included 756 leads (n = 565 anchored and n = 191 unanchored) from 249 patients. In unanchored leads, migration occurred in 16 leads (8.4%) from 13 patients (21.0%). In anchored leads, migration occurred in 8 leads (1.4%) from 5 patients (2.7%). Fracture in unanchored leads occurred in 6 leads (3.1%) from 6 patients (9.7%). Fractures in anchored leads occurred in 11 leads (1.9%) from 9 patients (4.8%). The migration survival distributions for the anchored and unanchored leads were statistically significantly different (p < 0.01) with decreased survival for unanchored leads (hazard ratio = 5.8, 95% confidence interval [CI] = 2.2-15.5). Discussion:We found that anchoring DRG-S leads significantly reduces lead migration when compared to leads placed without an anchor. There was no significant difference in fracture rate between anchored and unanchored leads.

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Section: Introductionmentioning

confidence: 99%

Lead migration and fracture rate in dorsal root ganglion stimulation using anchoring and non‐anchoring techniques: A multicenter pooled data analysis

et al. 2021

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“… 7 Another recent study by Horan and colleagues determined that the most common complications were defective electrodes (39%), an inability to replace electrodes (21%), migrated electrode (15%), electrode fragment left in patients (12%), nerve damage (9%) and infection (6%). 8 Neither of the studies mention itch or pruritus as a possible complication.…”

Section: Literature Reviewmentioning

confidence: 99%

Case Study: Neuropathic Itching Following S3 and S4 Dorsal Root Ganglion Stimulator Trial

Strand

Mahdi

Schatman³

et al. 2021

JPR

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“…We read the cohort report of Horan et al (1) with interest. Disparate complication rates in the dorsal root ganglion (DRG) Stimulation literature are cited in driving their report which is notable for good efficacy, but a high complication rate.…”

Section: To the Editormentioning

confidence: 99%

Response to “Complications and Effects of Dorsal Root Ganglion Stimulation in the Treatment of Chronic Neuropathic Pain: A Nationwide Cohort Study in Denmark”

Lubenow

Nijhuis

2020

Neuromodulation: Technology at the Neural Interface

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Complications and Effects of Dorsal Root Ganglion Stimulation in the Treatment of Chronic Neuropathic Pain: A Nationwide Cohort Study in Denmark

Cited by 31 publications

References 34 publications

Lead migration and fracture rate in dorsal root ganglion stimulation using anchoring and non‐anchoring techniques: A multicenter pooled data analysis

Lead migration and fracture rate in dorsal root ganglion stimulation using anchoring and non‐anchoring techniques: A multicenter pooled data analysis

Case Study: Neuropathic Itching Following S3 and S4 Dorsal Root Ganglion Stimulator Trial

Response to “Complications and Effects of Dorsal Root Ganglion Stimulation in the Treatment of Chronic Neuropathic Pain: A Nationwide Cohort Study in Denmark”

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