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Retrospective Case Series on the Treatment of Painful Diabetic Peripheral Neuropathy With Dorsal Root Ganglion Stimulation.
Neuromodulation. 2018 Dec; 21(8):787-792.N

Abstract

BACKGROUND

The dorsal root ganglion (DRG) has been identified as an important neural structure in the development and maintenance of chronic pain. We present a retrospective case series of patients with refractory painful diabetic peripheral neuropathy (PDPN) that underwent electrical stimulation of the DRG and report on changes in their overall perceived pain and complication rates.

METHODS

Ten diabetic males (mean age 65.2 [SD 8.8] years) with painful symptoms of the lower limbs were enrolled and trialed with up to four quadripolar percutaneous DRG stimulation leads between L2 and L5 spinal levels. Patients received a fully implantable neurostimulation system (Abbott Laboratories, Sunnyvale, CA, USA) immediately or after a successful trial period (>50% reduction in pain). Overall perceived pain was measured by visual analogue scale (VAS) at baseline, one-week postimplantation and one-, three-, six-, and twelve-month follow-up (n = 5).

RESULTS

Ten patients were included in this retrospective study. Seven of these subjects received permanent stimulator implants after successful externalized or intraoperative trials. Two of those patients subsequently required explantation, due to failure to capture primary pain area (n = 1) and personal reasons (n = 1). For the five subjects that proceeded to clinical follow-ups, baseline VAS was reduced by an average of 63.90% (SD 21.39; p < 0.001) postimplantation. For four patients with available 12-month follow-up data, mean relative reduction in overall perceived pain averaged 64.16% (SD 35.8; p< 0.001).

CONCLUSION

Early findings from this small retrospective case series, suggest DRG is a safe and effective neuromodulation modality to improve painful symptoms in PDPN patients. Future prospective trials are required to further investigate the use of DRG stimulation for this clinical indication.

Authors+Show Affiliations

Department of Pain, The James Cook University Hospital, Middlesbrough, UK.The Pain Doctors, Benowa, QLD, Australia.Uppsala University Hospital, Uppsala, SE, Sweden.Flinders Medical Centre, Bedford Park, SA, Australia.Sint Antonius Hospital, Nieuwegein, The Netherlands.Institute of Clinical Neurosciences, Bristol, UK.Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany.Abbott Laboratories, Sunnyvale, CA, USA.Abbott Laboratories, Sunnyvale, CA, USA.Abbott Laboratories, Sunnyvale, CA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29575331

Citation

Eldabe, Sam, et al. "Retrospective Case Series On the Treatment of Painful Diabetic Peripheral Neuropathy With Dorsal Root Ganglion Stimulation." Neuromodulation : Journal of the International Neuromodulation Society, vol. 21, no. 8, 2018, pp. 787-792.
Eldabe S, Espinet A, Wahlstedt A, et al. Retrospective Case Series on the Treatment of Painful Diabetic Peripheral Neuropathy With Dorsal Root Ganglion Stimulation. Neuromodulation. 2018;21(8):787-792.
Eldabe, S., Espinet, A., Wahlstedt, A., Kang, P., Liem, L., Patel, N. K., Vesper, J., Kimber, A., Cusack, W., & Kramer, J. (2018). Retrospective Case Series on the Treatment of Painful Diabetic Peripheral Neuropathy With Dorsal Root Ganglion Stimulation. Neuromodulation : Journal of the International Neuromodulation Society, 21(8), 787-792. https://doi.org/10.1111/ner.12767
Eldabe S, et al. Retrospective Case Series On the Treatment of Painful Diabetic Peripheral Neuropathy With Dorsal Root Ganglion Stimulation. Neuromodulation. 2018;21(8):787-792. PubMed PMID: 29575331.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retrospective Case Series on the Treatment of Painful Diabetic Peripheral Neuropathy With Dorsal Root Ganglion Stimulation. AU - Eldabe,Sam, AU - Espinet,Anthony, AU - Wahlstedt,Anders, AU - Kang,Porhan, AU - Liem,Liong, AU - Patel,Nikunj K, AU - Vesper,Jan, AU - Kimber,Alicia, AU - Cusack,William, AU - Kramer,Jeffery, Y1 - 2018/03/25/ PY - 2017/03/13/received PY - 2017/11/27/revised PY - 2018/01/04/accepted PY - 2018/3/27/pubmed PY - 2019/1/19/medline PY - 2018/3/26/entrez KW - Chronic pain KW - diabetic polyneuropathy KW - dorsal root ganglion stimulation KW - lower limb pain KW - neuromodulation SP - 787 EP - 792 JF - Neuromodulation : journal of the International Neuromodulation Society JO - Neuromodulation VL - 21 IS - 8 N2 - BACKGROUND: The dorsal root ganglion (DRG) has been identified as an important neural structure in the development and maintenance of chronic pain. We present a retrospective case series of patients with refractory painful diabetic peripheral neuropathy (PDPN) that underwent electrical stimulation of the DRG and report on changes in their overall perceived pain and complication rates. METHODS: Ten diabetic males (mean age 65.2 [SD 8.8] years) with painful symptoms of the lower limbs were enrolled and trialed with up to four quadripolar percutaneous DRG stimulation leads between L2 and L5 spinal levels. Patients received a fully implantable neurostimulation system (Abbott Laboratories, Sunnyvale, CA, USA) immediately or after a successful trial period (>50% reduction in pain). Overall perceived pain was measured by visual analogue scale (VAS) at baseline, one-week postimplantation and one-, three-, six-, and twelve-month follow-up (n = 5). RESULTS: Ten patients were included in this retrospective study. Seven of these subjects received permanent stimulator implants after successful externalized or intraoperative trials. Two of those patients subsequently required explantation, due to failure to capture primary pain area (n = 1) and personal reasons (n = 1). For the five subjects that proceeded to clinical follow-ups, baseline VAS was reduced by an average of 63.90% (SD 21.39; p < 0.001) postimplantation. For four patients with available 12-month follow-up data, mean relative reduction in overall perceived pain averaged 64.16% (SD 35.8; p< 0.001). CONCLUSION: Early findings from this small retrospective case series, suggest DRG is a safe and effective neuromodulation modality to improve painful symptoms in PDPN patients. Future prospective trials are required to further investigate the use of DRG stimulation for this clinical indication. SN - 1525-1403 UR - https://www.unboundmedicine.com/medline/citation/29575331/Retrospective_Case_Series_on_the_Treatment_of_Painful_Diabetic_Peripheral_Neuropathy_With_Dorsal_Root_Ganglion_Stimulation_ L2 - https://doi.org/10.1111/ner.12767 DB - PRIME DP - Unbound Medicine ER -