Advertisement

Sacral Dorsal Root Ganglion Spinal Stimulation

  • Jeffery Rowe
  • Timothy R. Deer
  • Pankaj Mehta
  • Jason E. Pope
  • Denis G. Patterson
  • Javid Baksh
  • Maged Guirguis
Chapter

Abstract

Sacral dorsal root ganglion stimulation (DRGS) is a valuable tool used in the treatment of chronic neuropathic pain, chronic regional pain syndrome (CRPS) Types I and Type II in the foot and/or ankle. Although both spinal stimulation and DRGS apply energy to disrupt pain signals, DRGS is able to more specifically target areas of focal neuropathic pain. The specialized lead placement developed ensures reproducible results and stability in amount of pain relief provided. Significantly better outcomes are achievable when utilizing sacral DRGS and properly executed lead placement technique in patients who suffer from focal neuropathic pain in the feet and/or ankles without diffuse pain within the lumbar spine and/or lower extremities.

Keywords

Dorsal root ganglion stimulation Neurostimulation Neuromodulation Spinal cord stimulation DRG stimulation Sacral DRG Sacral dorsal root ganglion stimulation S1 and S2 DRG lead placement S1 and S2 DRG S1 and S2 dorsal root ganglion stimulation 

Recommended Reading

  1. 1.
    Deer TR, Pope JE. Dorsal root ganglion stimulation approval by the Food and Drug Administration: advice on evolving the process. Expert Rev Neurother. 2016;16:1123–5.CrossRefGoogle Scholar
  2. 2.
    Deer TR, et al. Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial. Pain. 2017;158:669–81.CrossRefGoogle Scholar
  3. 3.
    Devor M. Unexplained peculiarities of the dorsal root ganglion. Pain. 1999;(Suppl 6):S27–35.CrossRefGoogle Scholar
  4. 4.
    Gemes G, et al. Failure of action potential propagation in sensory neurons: mechanisms and loss of afferent filtering in C-type units after painful nerve injury. J Physiol. 2013;591:1111–31.CrossRefGoogle Scholar
  5. 5.
    Grigsby E, Deer T, Weiner R, Wilcosky B, Kramer J. Prospective, multicenter clinical trial studying dorsal root ganglion stimulation in the treatment of back pain. 2010.Google Scholar
  6. 6.
    Hasegawa T, Mikawa Y, Watanabe R, An HS. Morphometric analysis of the lumbosacral nerve roots and dorsal root ganglia by magnetic resonance imaging. Spine. 1996;21:1005–9.CrossRefGoogle Scholar
  7. 7.
    Institute of Medicine (US) Committee on Advancing Pain Research, Care, and Education. Relieving pain in America: a blueprint for transforming prevention, care, education, and research: National Academies Press (US); 2011.Google Scholar
  8. 8.
    Kandel ER. Principles of Neural Science, Fifth Edition: McGraw Hill Professional; 2013.Google Scholar
  9. 9.
    Krames ES. The role of the dorsal root ganglion in the development of neuropathic pain. Pain Med. Malden Mass. 2014;15:1669–85.CrossRefGoogle Scholar
  10. 10.
    Liem L, et al. A multicenter, prospective trial to assess the safety and performance of the spinal modulation dorsal root ganglion neurostimulator system in the treatment of chronic pain. Neuromodulation. 2013;16:471–82; discussion 482.CrossRefGoogle Scholar
  11. 11.
    Macfarlane GJ. The epidemiology of chronic pain. Pain. 2016;157:2158–9.CrossRefGoogle Scholar
  12. 12.
    Panjabi MM, Duranceau J, Goel V, Oxland T, Takata K. Cervical human vertebrae. Quantitative three-dimensional anatomy of the middle and lower regions. Spine. 1991;16:861–9.CrossRefGoogle Scholar
  13. 13.
    Panjabi MM, et al. Thoracic human vertebrae. Quantitative three-dimensional anatomy. Spine. 1991;16:888–901.CrossRefGoogle Scholar
  14. 14.
    Pope JE, Deer TR, Kramer J. A systematic review: current and future directions of dorsal root ganglion therapeutics to treat chronic pain. Pain Med. Malden Mass. 2013;14:1477–96.CrossRefGoogle Scholar
  15. 15.
    Sapunar D, Kostic S, Banozic A, Puljak L. Dorsal root ganglion - a potential new therapeutic target for neuropathic pain. J Pain Res. 2012;5:31–8.CrossRefGoogle Scholar
  16. 16.
    Struijk JJ, Holsheimer J, Boom HB. Excitation of dorsal root fibers in spinal cord stimulation: a theoretical study. IEEE Trans Biomed Eng. 1993;40:632–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jeffery Rowe
    • 1
  • Timothy R. Deer
    • 2
  • Pankaj Mehta
    • 3
  • Jason E. Pope
    • 4
  • Denis G. Patterson
    • 5
  • Javid Baksh
    • 6
  • Maged Guirguis
    • 7
  1. 1.Main Line Spine & Main Line Spine Surgery CenterKing of PrussiaUSA
  2. 2.The Spine and Nerve Center of the VirginiasCharlestonUSA
  3. 3.Pain Specialists of AustinKilleenUSA
  4. 4.Evolve Restorative CenterSanta RosaUSA
  5. 5.Nevada Advanced Pain SpecialistsRenoUSA
  6. 6.Premier Pain SolutionsAshevilleUSA
  7. 7.Ochsner Medical CenterJeffersonUSA

Personalised recommendations