• Rosh Bharthi, Dorian M Kusyk, Michael Patterson, and Nestor D Tomycz.
• Department of Medical Education, Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania, USA. Electronic address: rbharthi07123@med.lecom.edu.
• World Neurosurg. 2024 Oct 18.

ObjectiveDorsal root ganglion (DRG) stimulator leads were designed to be placed percutaneously, yet open surgical placement via laminectomy is an option. We present the largest series to date of surgically-placed DRG stimulators and the first series where open surgical implantation was the chosen technique and not a salvage procedure.MethodsA retrospective review of a prospective database of DRG implants identified 17 patients who had open lumbosacral DRG lead placement performed by a single surgeon between October 2021 and April 2023. Descriptive statistics, fluoroscopy exposure times, and complications were reported. The window of data collection was 1 month preoperatively to 12 months postoperatively. Phone interviews were conducted to collect information on pain outcomes and patient satisfaction.ResultsWe identified 17 patients (12 women, 5 men) who had lumbosacral DRG placement. Phone interviews were conducted for 10/17 patients, with mean follow-up of 11.9 months. 53% reduction in mean pain score was achieved (n = 10, P < 0.001). There were no infections, hematomas, or symptomatic lead migrations. One of 17 experienced a superficial dehiscence and 2 of 17 had an intraoperative repairable durotomy with no postoperative sequelae. Mean fluoroscopy time per lead was 15.4±9.9s (n = 10).ConclusionsOpen DRG lead placement via laminotomy/laminectomy is reported as a salvage procedure but may have comparable safety and efficacy profile to percutaneous implantation when utilized as the primary implantation method. Before establishing open DRG as an alternative permanent implantation method, more studies are needed to determine whether such benefits as less migration outweigh the risks of a more invasive implantation procedure.Copyright © 2024. Published by Elsevier Inc.

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