• Timothy R Deer, Robert M Levy, Jeffery Kramer, Lawrence Poree, Kasra Amirdelfan, Eric Grigsby, Peter Staats, Abram H Burgher, James Scowcroft, Stan Golovac, Leonardo Kapural, Richard Paicius, Jason E Pope, Sam Samuel, Porter McRoberts William W Holy Cross Hospital, Ft. Lauderdale, FL, USA., Michael Schaufele, Allen W Burton, Adil Raza, Filippo Agnesi, and Nagy Mekhail.
• Center for Pain Relief, Charleston, WV, USA.
• Neuromodulation. 2019 Dec 1; 22 (8): 930-936.

ObjectivesThis was a sub-analysis of the ACCURATE clinical trial that evaluated the accuracy and necessity of targeting paresthesia coverage of painful areas with dorsal root ganglion (DRG) stimulation vs. tonic spinal cord stimulation (SCS).Materials And MethodsOn diagrams of the torso and lower limbs, subjects marked where they felt pain at baseline and paresthesias at three months postimplant. Seventy-five subjects (41 DRG and 34 SCS) with diagrams of sufficient quality were scanned, digitized, and included in this analysis. Subject completed diagrams were digitized and superimposed with a grid of 1398 squares. Quantification of the percentage of bodily areas affected by pain and stimulation induced paresthesias was performed.ResultsThe percent of painful areas covered by paresthesia was significantly lower for DRG subjects than for SCS subjects (13% vs. 28% of the painful regions, p < 0.05), possibly because significantly more DRG subjects felt no paresthesia during stimulation when compared to SCS subjects (13/41 DRG vs. 3/34 SCS) (p < 0.05). The amount of paresthesia produced outside the painful areas (unrequired paresthesia) was significantly lower in DRG subjects than that of SCS subjects. On average, the percent of unrequired paresthesia was only 20% of the subjects' total painful body surface area in the DRG group compared to 210% in the SCS group (p < 0.01).ConclusionsThe results of this ACCURATE study sub-analysis show that DRG stimulation produces paresthesias, on average, that are less frequent, less intense, with a smaller footprint on the body and less dependent on positional changes.© 2019 International Neuromodulation Society.

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