Dorsal Root Ganglion Stimulation for the Treatment of Chronic Neuropathic Knee Pain

Martin, Sean; Macey, Alistair R. M.; Raghu, Ashley L B; Edwards, Tamara; Watson, Christopher N.; Bojanić, Stana; FitzGerald, James J.; Green, Alexander L.

doi:10.1016/j.wneu.2020.07.102

Cited by 15 publications

(19 citation statements)

References 16 publications

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“…Total of 5 patients had complications (16.7%) Morgalla et al (2019) [ 52 ] Germany Prospective with single arm Multiple institutional funding sources 12 Unilateral localized neuropathic pain in the lower limbs or inguinal region 51.8 ± 6.05 DRG-S At 1 and 6 months follow-ups, N2–P2 amplitudes were significantly greater and NRS scores significantly lower compared to baseline. There was a negative correlation between LEP amplitudes and NRS scores Martin et al (2020) [ 53 ] UK Retrospective Grant funding from National Institute for Health Research Oxford Biomedical Research Centre Total: 14 Single L3 lead: 8 Single L4 lead: 1 L3 and L4 leads: 3 Chronic neuropathic knee pain 49.2 DRG-S Median preoperative NRS was 8.5 and median postoperative NRS was 2. The median improvement in pain score was 80%.…”

Section: Resultsmentioning

confidence: 99%

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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%

“…Similarly, Martin et al [ 69 ] conducted a secondary analysis of a prospective study of 14 patients with neuropathic knee pain. Of 14 patients, 12 had a successful trial and received a permanent implant, including five patients with postsurgical knee pain and seven patients with pain secondary to traumatic injury.…”

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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“…Twelve of the 14 had greater than 50% reduction of their pain. 227 Similarly, in the FOCUS study, 12 patients with total knee replacements had successful treatment of their pain after DRG stimulation. 228 The efficacy of DRG treatment for post-operative pain associated with TKA has additionally been supported by Morgella et al’s outcomes, with 27 patients implanted with DRG systems demonstrating a reduction in VAS of approximately 69%.…”

Section: Recommendations Regarding Neurostimulationmentioning

confidence: 96%

Consensus Guidelines on Interventional Therapies for Knee Pain (STEP Guidelines) from the American Society of Pain and Neuroscience

Hunter¹,

Deer²,

Jones³

et al. 2022

JPR

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Knee pain is second only to the back as the most commonly reported area of pain in the human body. With an overall prevalence of 46.2%, its impact on disability, lost productivity, and cost on healthcare cannot be overlooked. Due to the pervasiveness of knee pain in the general population, there are no shortages of treatment options available for addressing the symptoms. Ranging from physical therapy and pharmacologic agents to interventional pain procedures to surgical options, practitioners have a wide array of options to choose from – unfortunately, there is no consensus on which treatments are “better” and when they should be offered in comparison to others. While it is generally accepted that less invasive treatments should be offered before more invasive ones, there is a lack of agreement on the order in which the less invasive are to be presented. In an effort to standardize the treatment of this extremely prevalent pathology, the authors present an all-encompassing set of guidelines on the treatment of knee pain based on an extensive literature search and data grading for each of the available alternative that will allow practitioners the ability to compare and contrast each option.

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“…1 Since then, smaller studies have demonstrated the efficacy of DRG-S in treating other neuropathic pain conditions and mixed nociceptive pain syndromes, including axial low back pain and postsurgical joint pain. [2][3][4][5] Although DRG-S can produce paresthesia in the covered anatomy at high stimulation amplitudes, paresthesia is usually neither required nor preferred. Unlike paresthesia-dependent conventional SCS, DRG-S is typically applied at subthreshold amplitudes, which are imperceptible.…”

Section: Introductionmentioning

confidence: 99%

Intermittent Dorsal Root Ganglion Stimulation Is as Efficacious as Standard Continuous Dosing in Treating Chronic Pain: Results From a Randomized Controlled Feasibility Trial

Chapman

Tupper

Yang

et al. 2022

Neuromodulation: Technology at the Neural Interface

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Dorsal Root Ganglion Stimulation for the Treatment of Chronic Neuropathic Knee Pain

Cited by 15 publications

References 16 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

Consensus Guidelines on Interventional Therapies for Knee Pain (STEP Guidelines) from the American Society of Pain and Neuroscience

Intermittent Dorsal Root Ganglion Stimulation Is as Efficacious as Standard Continuous Dosing in Treating Chronic Pain: Results From a Randomized Controlled Feasibility Trial

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