Cutaneous vasodilation during dorsal column stimulation is mediated by dorsal roots and CGRP. Clin Neurophysiol Off J Int Fed Clin Neurophysiol 2004 115:1239-1248.Ĭroom JE, Foreman RD, Chandler MJ, Barron KW. Uncovering the mechanism(s) of action of deep brain stimulation: activation, inhibition, or both. McIntyre CC, Savasta M, Kerkerian-Le Goff L et al. Neuromodulation J Int Neuromodulation Soc 2013 16:304-311. Effect of electrical field stimulation on dorsal root ganglion neuronal function. Koopmeiners AS, Mueller S, Kramer J, Hogan QH. © 2019 International Neuromodulation Society. Surgery itself in this region is more complication prone and challenging.ĭorsal root ganglion stimulation neuromodulation neuropathic pain. A modified surgical approach has to be used when compared with lumbar DRG electrode placement. She completely recovered within three months.Ĭervical and upper thoracic DRG stimulation resulted in good overall response rates to trialing and similar pain relief when compared to DRG stimulation for groin and lower limb pain. One patient developed a transient paresis of the arm caused by the procedure. 77.8% of the patients reported a pain relief of at least 50% after three months. The average pain relief after three months compared to the baseline was of 60.9% (mean VAS 8.5 to VAS 3.2). Out of all 20 patients trialed, 18 were successfully trialed and implanted with a permanent stimulation system. Routine clinical follow-up was performed during reprogramming sessions. All patients were trialed with externalized electrodes prior to permanent pulse generator implantation. Main pain etiologies were trauma, spine surgery, postherpetic neuralgia, and peripheral nerve surgery. All patients suffered from chronic neuropathic pain unresponsive to best medical treatment. We report a consecutive series of 20 patients treated with DRG stimulation in the upper thoracic and cervical region. Data on surgical technique, outcome and complications rates of DRG in this region are limited. This offers new therapeutic options especially in the treatment of neuropathic pain states of the upper extremities. While being primarily used in the lumbar region, dorsal root ganglion (DRG) stimulation also can be used in the upper thoracic and cervical region with slight alterations of the surgical approach. Dorsal root ganglion stimulation is a meanwhile established but rather new technique of neuromodulation to treat chronic pain states of different origin.
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