4.6 Article

A prospective long-term follow-up of dorsal root ganglion stimulation for the management of chronic intractable pain

Journal

PAIN
Volume 163, Issue 4, Pages 702-710

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/j.pain.0000000000002405

Keywords

Chronic pain; Neurostimulation; Complex regional pain syndrome; Causalgia; Dorsal root ganglion stimulation; Back pain; Leg pain; Neuropathic pain

Funding

  1. Spinal Modulation

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This study aimed to report on the long-term follow-up of DRG stimulation for intractable chronic pain. The findings showed that DRG stimulation can effectively relieve pain and improve quality of life in patients suffering from neuropathic pain. However, there was a high revision rate within the first 24 months and some patients experienced shorter than expected battery life.
Initial clinical studies have shown that the stimulation of the dorsal root ganglion (DRG) can significantly reduce chronic intractable pain. However, clinical data on long-term results and complications of these systems are limited. The aim of this prospective study is to report on a single center long-term follow-up of DRG stimulation for intractable chronic pain. Participants were implanted with DRG stimulation devices between 2013 and 2015 with an observation period of 24 months. Patients were contacted again in 2020 fora final follow-up (ie, between 5 and 7 years postimplantation). Forty-two participants were recruited, of whom 32 received the fully implantable pulse generator (IPG). At the final follow-up, 50% (16/32) of participants were still using DRG stimulation. Two participants still had the original IPG and 14 had received a replacement IPG. Pain scores were significantly reduced at 24 months, mean difference 1.7 (95% confidence interval: 0.2-3.3, P = 0.03), and at the last follow-up, mean difference 2.1 (95% confidence interval: 0.3-4, P = 0.03). Significant improvements were observed for health-related quality of life. The findings were generally robust to imputation methods of missing data. Implantable pulse generators of 8 patients were explanted because of dissatisfaction with pain relief. In conclusion, DRG stimulation can provide effective pain relief and improved quality of life in patients suffering with neuropathic pain, although this study had a revision rate of 42% within the first 24 months, and 56% of IPGs that were replaced because of battery depletion had a shorter than expected battery life.

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