Dorsal Root Ganglion Stimulation for the Management of Intractable Painful Polyneuropathy: A Prospective Pilot Study

Koetsier, Eva; Kuijk, Sander M. J. van; Melli, Giorgia; Dukanac, Jasmina; Barbero, Marco; Zundert, Jan Van; Joosten, Elbert A.J.; Maino, Paolo

doi:10.1111/ner.13336

Cited by 7 publications

(13 citation statements)

References 77 publications

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“…A prospective pilot study by Koetsier et al [ 55 ] evaluated DRG-S on nine patients with intractable large fiber polyneuropathy (Table 5 ). Etiologies included type II diabetes, chemotherapy-induced peripheral neuropathy (CIPN), chronic inflammatory demyelinating polyradiculoneuropathy, and idiopathic.…”

Section: Resultsmentioning

confidence: 99%

“…Pain decreased from 8 to 4 Mata et al (2020) [ 59 ] USA Case report No funding 1 Frostbite with refractory burning and pain in the foot 65 DRG-S Pt had significant improvement in his pain and continued to have 90% improvement at 2 years. He was weaned off oxycodone, amitriptyline, and gabapentin; his fentanyl patch was lowered to 25 μg every 72 h and he was able to return to work Kretzschmar et al (2021) [ 60 ] Germany Case report No funding 1 Central post-stroke pain in the lower extremity after medullary infarction 53 DRG-S Pt was successfully weaned off opioids after implantation Koetsier et al (2021) [ 55 ] Switzerland Prospective non-comparative No funding 9 Chronic painful polyneuropathy in the lower limbs 63.2 ± 8.7 DRG-S L5 and S1 8/9 pts had a successful DRG-S trial, and 7 underwent implantation. Daytime pain decreased from a median (IQR) NRS score of 7.0 (5.9–8.3) to 2.0 (1.0–3.5) and 3.0 (1.6–4.9) in the 1st week and at 6 months after implantation.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Dorsal Root Ganglion Stimulation for Lower Extremity Neuropathic Pain Syndromes: An Evidence-Based Literature Review

et al. 2022

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Dorsal root ganglion stimulation (DRG-S) is a form of selective neuromodulation therapy that targets the dorsal root ganglion. DRG-S offers analgesia in a variety of chronic pain conditions and is approved for treatment of complex regional pain syndrome (CRPS) by the US Food and Drug Administration (FDA). There has been increasing utilization of DRG-S to treat various neuropathic pain syndromes of the lower extremity, although evidence remains limited to one randomized controlled trial and 39 observational studies. In this review, we appraised the current evidence for DRG-S in the treatment of lower extremity neuropathic pain using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria. The primary outcome was change in pain intensity after DRG-S compared to baseline. We stratified presentation of results based of type of neuropathy (CRPS, painful diabetic neuropathy, mononeuropathy, polyneuropathy) as well as location of neuropathy (hip, knee, foot). Future powered randomized controlled trials with homogeneous participants are warranted.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Dorsal Root Ganglion Stimulation for Lower Extremity Neuropathic Pain Syndromes: An Evidence-Based Literature Review

et al. 2022

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“…There are only two small prospective studies and one retrospective study, and seven case reports of application of DRG-S for varying causes of PN. 58,[127][128][129][130][131][132][133][134] Reports included diabetic PN, painful small-fiber PN, idiopathic PN, polysensory PN, hereditary sensory and autonomic PN, PN associated with Lyme's disease, and chemotherapeutic agent-induced PN. Follow-up in most cases was as short as 6 weeks to 6-12 months.…”

Section: Peripheral Neuropathymentioning

confidence: 99%

“…Koetsier et al in a prospective study treating polyneuropathy reported 8 of 9 patients having a successful trial, with 7 patients implanted. 131 Leads were placed at the L5 in 95% of cases and S1 in 44% of cases. At 6 months' follow-up they found a 57% improvement in VAS, a 50% improvement in anxiety and depression as measured by HADS, a 60% improvement in BPI pain intensity, and a 20% improvement in quality of life as measured by the EQ-5D.…”

Section: Peripheral Neuropathymentioning

confidence: 99%

Best Practices for Dorsal Root Ganglion Stimulation for Chronic Pain: Guidelines from the American Society of Pain and Neuroscience

Chapman¹,

Sayed²,

Lamer³

et al. 2023

JPR

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With continued innovations in neuromodulation comes the need for evolving reviews of best practices. Dorsal root ganglion stimulation (DRG-S) has significantly improved the treatment of complex regional pain syndrome (CRPS), and it has broad applicability across a wide range of other conditions. Through funding and organizational leadership by the American Society for Pain and Neuroscience (ASPN), this best practices consensus document has been developed for the selection, implantation, and use of DRG stimulation for the treatment of chronic pain syndromes. This document is composed of a comprehensive narrative literature review that has been performed regarding the role of the DRG in chronic pain and the clinical evidence for DRG-S as a treatment for multiple pain etiologies. Best practice recommendations encompass safety management, implantation techniques, and mitigation of the potential complications reported in the literature. Looking to the future of neuromodulation, DRG-S holds promise as a robust intervention for otherwise intractable pain.

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“…1,21 Spinal cord stimulation (SCS) and DRG stimulation (DRGS) have reported effectiveness in the treatment of neuropathic pain. 14 Although conventional SCS often provides significant pain relief from whole limb pain, focal pains limited to discreet areas such as the hands, feet, and groin often prove difficult to target. 19 The higher levels of stimulation currents needed to provide sufficient coverage to the focal pain areas often result in stimulation of larger areas that were otherwise pain free.…”

Section: Introductionmentioning

confidence: 99%

A prospective long-term follow-up of dorsal root ganglion stimulation for the management of chronic intractable pain

Eldabe

Copley

Gulve

et al. 2021

Pain

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Initial clinical studies have shown that the stimulation of the dorsal root ganglion (DRG) can significantly reduce chronic intractable pain. However, clinical data on long-term results and complications of these systems are limited. The aim of this prospective study is to report on a single center long-term follow-up of DRG stimulation for intractable chronic pain. Participants were implanted with DRG stimulation devices between 2013 and 2015 with an observation period of 24 months. Patients were contacted again in 2020 for a final follow-up (ie, between 5 and 7 years postimplantation). Forty-two participants were recruited, of whom 32 received the fully implantable pulse generator (IPG). At the final follow-up, 50% (16/32) of participants were still using DRG stimulation. Two participants still had the original IPG and 14 had received a replacement IPG. Pain scores were significantly reduced at 24 months, mean difference 1.7 (95% confidence interval: 0.2-3.3, P 5 0.03), and at the last follow-up, mean difference 2.1 (95% confidence interval: 0.3-4, P 5 0.03). Significant improvements were observed for health-related quality of life. The findings were generally robust to imputation methods of missing data. Implantable pulse generators of 8 patients were explanted because of dissatisfaction with pain relief. In conclusion, DRG stimulation can provide effective pain relief and improved quality of life in patients suffering with neuropathic pain, although this study had a revision rate of 42% within the first 24 months, and 56% of IPGs that were replaced because of battery depletion had a shorter than expected battery life.

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Dorsal Root Ganglion Stimulation for the Management of Intractable Painful Polyneuropathy: A Prospective Pilot Study

Cited by 7 publications

References 77 publications

Dorsal Root Ganglion Stimulation for Lower Extremity Neuropathic Pain Syndromes: An Evidence-Based Literature Review

Dorsal Root Ganglion Stimulation for Lower Extremity Neuropathic Pain Syndromes: An Evidence-Based Literature Review

Best Practices for Dorsal Root Ganglion Stimulation for Chronic Pain: Guidelines from the American Society of Pain and Neuroscience

A prospective long-term follow-up of dorsal root ganglion stimulation for the management of chronic intractable pain

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