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Spinal cord stimulation of the dorsal root ganglion for groin pain-a retrospective review.
Pain Pract 2015; 15(4):293-9PP

Abstract

BACKGROUND

Spinal cord stimulation (SCS) is a standard treatment option for chronic neuropathic pain. However, some anatomical pain distributions are known to be difficult to cover with traditional SCS-induced paresthesias and/or may also induce additional, unwanted stimulation. We present the results from a retrospective review of data from patients with groin pain of various etiologies treated using neuromodulation of the dorsal root ganglion (DRG).

METHODS

Data from 29 patients with neuropathic groin pain were reviewed. Patients underwent trial therapy where specifically designed leads were implanted at the target DRGs between T12 and L4. Patients who had a successful trial (> 50% improvement) received the fully implantable neuromodulation system. Pain scores were captured on a visual analog scale (VAS) at baseline and at regular follow-up visits.

RESULTS

Twenty-five patients (86.2%) received fully implantable neurostimulators, and the average follow-up period was 27.8 ± 4.3 (standard error of the mean, SEM) weeks. The average pain reduction was 71.4 ± 5.6%, and 82.6% (19/23) of patients experienced a > 50% reduction in their pain at the latest follow-up. Individual cases showed improvement with a variety of etiologies and pain distributions; a subanalysis of postherniorrhaphy cohort also showed significant improvement.

CONCLUSIONS

Early findings suggest that neuromodulation of the DRG may be an effective treatment for chronic neuropathic pain conditions in the groin region. This technique offers a useful alternative for pain conditions that do not always respond optimally to traditional SCS therapy. Neuromodulation of the DRG provided excellent cross-dermatomal paresthesia coverage, even in cases with patients with discrete pain areas. The therapy can be specific, sustained, and independent of body position.

Authors+Show Affiliations

Department of Functional Neurosurgery, University Hospital of Düsseldorf, Düsseldorf, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24690212

Citation

Schu, Stefan, et al. "Spinal Cord Stimulation of the Dorsal Root Ganglion for Groin Pain-a Retrospective Review." Pain Practice : the Official Journal of World Institute of Pain, vol. 15, no. 4, 2015, pp. 293-9.
Schu S, Gulve A, ElDabe S, et al. Spinal cord stimulation of the dorsal root ganglion for groin pain-a retrospective review. Pain Pract. 2015;15(4):293-9.
Schu, S., Gulve, A., ElDabe, S., Baranidharan, G., Wolf, K., Demmel, W., ... Liem, L. (2015). Spinal cord stimulation of the dorsal root ganglion for groin pain-a retrospective review. Pain Practice : the Official Journal of World Institute of Pain, 15(4), pp. 293-9. doi:10.1111/papr.12194.
Schu S, et al. Spinal Cord Stimulation of the Dorsal Root Ganglion for Groin Pain-a Retrospective Review. Pain Pract. 2015;15(4):293-9. PubMed PMID: 24690212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spinal cord stimulation of the dorsal root ganglion for groin pain-a retrospective review. AU - Schu,Stefan, AU - Gulve,Ashish, AU - ElDabe,Sam, AU - Baranidharan,Ganesan, AU - Wolf,Katharina, AU - Demmel,Walter, AU - Rasche,Dirk, AU - Sharma,Manohar, AU - Klase,Daniel, AU - Jahnichen,Gunnar, AU - Wahlstedt,Anders, AU - Nijhuis,Harold, AU - Liem,Liong, Y1 - 2014/04/01/ PY - 2013/10/02/received PY - 2014/01/10/accepted PY - 2014/4/3/entrez PY - 2014/4/3/pubmed PY - 2016/5/3/medline KW - dorsal root ganglion KW - dorsal root ganglion stimulation KW - groin pain KW - neuropathic pain KW - spinal cord stimulation SP - 293 EP - 9 JF - Pain practice : the official journal of World Institute of Pain JO - Pain Pract VL - 15 IS - 4 N2 - BACKGROUND: Spinal cord stimulation (SCS) is a standard treatment option for chronic neuropathic pain. However, some anatomical pain distributions are known to be difficult to cover with traditional SCS-induced paresthesias and/or may also induce additional, unwanted stimulation. We present the results from a retrospective review of data from patients with groin pain of various etiologies treated using neuromodulation of the dorsal root ganglion (DRG). METHODS: Data from 29 patients with neuropathic groin pain were reviewed. Patients underwent trial therapy where specifically designed leads were implanted at the target DRGs between T12 and L4. Patients who had a successful trial (> 50% improvement) received the fully implantable neuromodulation system. Pain scores were captured on a visual analog scale (VAS) at baseline and at regular follow-up visits. RESULTS: Twenty-five patients (86.2%) received fully implantable neurostimulators, and the average follow-up period was 27.8 ± 4.3 (standard error of the mean, SEM) weeks. The average pain reduction was 71.4 ± 5.6%, and 82.6% (19/23) of patients experienced a > 50% reduction in their pain at the latest follow-up. Individual cases showed improvement with a variety of etiologies and pain distributions; a subanalysis of postherniorrhaphy cohort also showed significant improvement. CONCLUSIONS: Early findings suggest that neuromodulation of the DRG may be an effective treatment for chronic neuropathic pain conditions in the groin region. This technique offers a useful alternative for pain conditions that do not always respond optimally to traditional SCS therapy. Neuromodulation of the DRG provided excellent cross-dermatomal paresthesia coverage, even in cases with patients with discrete pain areas. The therapy can be specific, sustained, and independent of body position. SN - 1533-2500 UR - https://www.unboundmedicine.com/medline/citation/24690212/Spinal_cord_stimulation_of_the_dorsal_root_ganglion_for_groin_pain_a_retrospective_review_ L2 - https://doi.org/10.1111/papr.12194 DB - PRIME DP - Unbound Medicine ER -