• Neuromodulation · Apr 2018

    Review

    The Efficacy and Safety of Dorsal Root Ganglion Stimulation as a Treatment for Neuropathic Pain: A Literature Review.

    • Conrad Harrison, Sarah Epton, Stana Bojanic, Alexander L Green, and James J FitzGerald.
    • John Radcliffe Hospital, University of Oxford Medical Sciences Office, Oxford, UK.
    • Neuromodulation. 2018 Apr 1; 21 (3): 225-233.

    ObjectiveDorsal root ganglion stimulation (DRGS) received its first regulatory approval (CE marking in Europe) in late 2011, and so its use is now almost six years old. Several thousand patients have already been treated, and a landmark trial in lower limb complex regional pain syndrome (CRPS) and causalgia has recently been published.MethodsIn this review we have summarized the literature to date on the use of DRGS in the treatment of neuropathic pain.ResultsThe results so far are encouraging, with reports of successful use in treating a wide range of indications including postsurgical pain, CRPS, and phantom pain. Treatment of failed back surgery syndrome (FBSS) appears less successful. The therapy is still young, and long term results are not yet available. There is now good randomized clinical trial (RCT) evidence that DRGS provides superior pain relief to spinal cord stimulation for CRPS and causalgia of the lower limb, and produces stimulation that is more posturally stable, with more precise paraesthesia coverage. However evidence of this quality for other indications and pain locations is lacking.ConclusionThere is now Class A RCT evidence that DRGS provides superior pain relief to SCS for CRPS and causalgia of the lower limb. In the coming years we hope that randomized controlled trials will be performed on an indication-by-indication basis, which, together with the publication of longer term follow-up data, will provide a more complete understanding of the role of DRGS in the treatment of neuropathic pain syndromes.© 2017 International Neuromodulation Society.

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