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Prospective Cohort Analysis of DRG Stimulation for Failed Back Surgery Syndrome Pain Following Lumbar Discectomy.
Pain Pract. 2019 02; 19(2):204-210.PP

Abstract

INTRODUCTION

Surgical lumbar discectomy is a commonly performed routine spinal procedure that is usually undertaken to alleviate lumbar radicular symptoms caused by a herniated intervertebral disc. Surgical lumbar discectomy can also lead to chronic postsurgical leg and/or back pain (failed back surgery syndrome [FBSS]), a condition that can be refractory to conventional medical management. Early clinical results on the use of dorsal root ganglion (DRG) stimulation for FBSS have supported the use of this treatment alternative.

METHODS

A multicenter, single-arm, observational cohort study enrolled patients who had chronic pain following surgical lumbar discectomy, had failed conservative treatments, and reported pain intensity of at least 6 out of 10 in the primary region of pain. Data were collected on pain, quality of life, disability, and mood at baseline and through 12 months.

RESULTS

Thirteen patients underwent a trial of DRG stimulation; 11 (84.6%; 95% confidence interval = 57.8% to 95.7%) had good outcomes and underwent permanent device placement. Pain was reduced from a score of 8.64 (±0.92) at baseline to 2.40 (±2.38; n = 9) after 12 months of treatment, a 72.05% average reduction (P < 0.001). Similar improvements were observed across the secondary clinical measures, and safety data were in line with published rates.

DISCUSSION

These results suggest that DRG stimulation induces pain relief in subjects diagnosed with FBSS. These reductions in pain were also associated with improvements in quality of life and disability. Additional prospective studies are warranted to further investigate this potential application of DRG stimulation, as well as to optimize patient selection, lead placement, and programming strategies.

Authors+Show Affiliations

Rijnstate Ziekenhuis, Velp, The Netherlands.St. Antonius Hospital, Nieuwegein, The Netherlands.Erasmus University, Rotterdam, The Netherlands.Diakonessenhuis Utrecht, Zeist, The Netherlands. Academic Medical Centre Amsterdam, Amsterdam, The Netherlands.Diakonessenhuis Utrecht, Zeist, The Netherlands. Academic Medical Centre Amsterdam, Amsterdam, The Netherlands.Elisabeth-Tweesteden Ziekenhuis, Tilburg, The Netherlands.Abbott Laboratories, Plano, Texas, U.S.A.

Pub Type(s)

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

Language

eng

PubMed ID

30269439

Citation

Kallewaard, Jan Willem, et al. "Prospective Cohort Analysis of DRG Stimulation for Failed Back Surgery Syndrome Pain Following Lumbar Discectomy." Pain Practice : the Official Journal of World Institute of Pain, vol. 19, no. 2, 2019, pp. 204-210.
Kallewaard JW, Nijhuis H, Huygen F, et al. Prospective Cohort Analysis of DRG Stimulation for Failed Back Surgery Syndrome Pain Following Lumbar Discectomy. Pain Pract. 2019;19(2):204-210.
Kallewaard, J. W., Nijhuis, H., Huygen, F., Wille, F., Zuidema, X., van de Minkelis, J., & Raza, A. (2019). Prospective Cohort Analysis of DRG Stimulation for Failed Back Surgery Syndrome Pain Following Lumbar Discectomy. Pain Practice : the Official Journal of World Institute of Pain, 19(2), 204-210. https://doi.org/10.1111/papr.12734
Kallewaard JW, et al. Prospective Cohort Analysis of DRG Stimulation for Failed Back Surgery Syndrome Pain Following Lumbar Discectomy. Pain Pract. 2019;19(2):204-210. PubMed PMID: 30269439.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective Cohort Analysis of DRG Stimulation for Failed Back Surgery Syndrome Pain Following Lumbar Discectomy. AU - Kallewaard,Jan Willem, AU - Nijhuis,Harold, AU - Huygen,Frank, AU - Wille,Frank, AU - Zuidema,Xander, AU - van de Minkelis,Johan, AU - Raza,Adil, Y1 - 2018/12/10/ PY - 2018/05/07/received PY - 2018/07/30/revised PY - 2018/08/05/accepted PY - 2018/10/1/pubmed PY - 2019/4/25/medline PY - 2018/10/1/entrez KW - back KW - dorsal root ganglia KW - failed back surgery syndrome KW - neuromodulation KW - neuropathic KW - pain KW - spinal cord stimulation KW - stimulation SP - 204 EP - 210 JF - Pain practice : the official journal of World Institute of Pain JO - Pain Pract VL - 19 IS - 2 N2 - INTRODUCTION: Surgical lumbar discectomy is a commonly performed routine spinal procedure that is usually undertaken to alleviate lumbar radicular symptoms caused by a herniated intervertebral disc. Surgical lumbar discectomy can also lead to chronic postsurgical leg and/or back pain (failed back surgery syndrome [FBSS]), a condition that can be refractory to conventional medical management. Early clinical results on the use of dorsal root ganglion (DRG) stimulation for FBSS have supported the use of this treatment alternative. METHODS: A multicenter, single-arm, observational cohort study enrolled patients who had chronic pain following surgical lumbar discectomy, had failed conservative treatments, and reported pain intensity of at least 6 out of 10 in the primary region of pain. Data were collected on pain, quality of life, disability, and mood at baseline and through 12 months. RESULTS: Thirteen patients underwent a trial of DRG stimulation; 11 (84.6%; 95% confidence interval = 57.8% to 95.7%) had good outcomes and underwent permanent device placement. Pain was reduced from a score of 8.64 (±0.92) at baseline to 2.40 (±2.38; n = 9) after 12 months of treatment, a 72.05% average reduction (P < 0.001). Similar improvements were observed across the secondary clinical measures, and safety data were in line with published rates. DISCUSSION: These results suggest that DRG stimulation induces pain relief in subjects diagnosed with FBSS. These reductions in pain were also associated with improvements in quality of life and disability. Additional prospective studies are warranted to further investigate this potential application of DRG stimulation, as well as to optimize patient selection, lead placement, and programming strategies. SN - 1533-2500 UR - https://www.unboundmedicine.com/medline/citation/30269439/Prospective_Cohort_Analysis_of_DRG_Stimulation_for_Failed_Back_Surgery_Syndrome_Pain_Following_Lumbar_Discectomy_ L2 - https://doi.org/10.1111/papr.12734 DB - PRIME DP - Unbound Medicine ER -