Dorsal Root Ganglion Stimulation: A Target for Neuromodulation Therapies

Dorsal Root Ganglion Stimulation Used for the Treatment of Chronic Neuropathic Pain in the Groin: A Single-Center Study With Long-Term Prospective Results in 34 Cases

“…DRG stimulation has been proven to selectively stimulate single nerve roots, which specifically cover the groin region, without additional paresthesias. It therefore achieves a more satisfactory result, when compared to SCS stimulation . An important study, the accurate study, included 152 subjects who were diagnosed with complex regional pain syndrome or causalgia in the lower extremities.…”

The Dorsal Root Ganglion as a Therapeutic Target for Chronic Pain

“…80,81 Because it has been established that electrical field stimulation of dissociated DRG cell bodies reduces the frequency and amplitude of their ectopic discharges, 82 it would logically follow that neuromodulation interventions applied to the DRG would be effective treatments for pain. The DRG has, indeed, been identified as a critical target for pain neuromodulation by a number of experts, 12,83,84 and preclinical work has provided converging evidence suggesting that modulating activity in the DRG could be a primary driver in pain treatments. [85][86][87] In humans, epidural SCS implantation techniques were modified to bring electrodes in close apposition to dorsal nerve roots (the proximal dendrites of neurons), with some success in achieving adequate paresthesia coverage of painful areas and resultant pain relief.…”

Management of Postherniorrhaphy Chronic Neuropathic Groin Pain: A Role for Dorsal Root Ganglion Stimulation

“…Nerve root stimulation for groin pain had disappointing long‐term results in a preliminary case report, but larger samples and more precise electrode placement may show better effectiveness. Indeed, a recently developed implantable neurostimulator with small, flexible leads for placement of electrodes against DRGs has showed promising results across a number of studies, including pain specific to the groin when leads are placed against the T11‐L2 DRGs (Figure ) or as empirically established with pre‐implant testing (Table ).…”

“…Based on this knowledge base and our clinical experience across with approximately 20 patients per year with postherniorrhaphy chronic neuropathic pain, we 68 3 of 3 case studies Case 1: 100% pain relief Case 2: 90% pain relief Case 3: 90% pain relief Liem, Krabbenbos, Kramer (2014) 63 1 of 4 case studies 88% reduction in VAS Weigel, Capelle, Krauss (2008) 64 2 of 3 case studies Case 1: Despite a successful trial, side effects appeared and effectiveness ceased by 12 months. 65,66 Not specified.…”

“…[58][59][60] However, a limitation of SCS with groin pain as with all axial pain distributions is that it is extremely difficult to achieve selective coverage of the painful regions 61,62 ; patients may find it necessary to tolerate "a pair of pants" of extraneous paresthesia in order to also capture the relatively discrete painful region. It has been proposed that dorsal root ganglia (DRG) stimulation may be a pain management option 63 that is a viable alternative to SCS for this pain distribution, because the recruitment of distally projecting sensory neurons may be more precisely selected to achieve a limited region of paresthesia. Nerve root stimulation for groin pain had disappointing long-term results in a preliminary case report, 64 but larger samples and more precise electrode placement may show better effectiveness.…”