Effectiveness and Safety of Dorsal Root Ganglion Stimulation for the Treatment of Chronic Pain: A Pooled Analysis

Frank J. P. M. Huygen, Jan Willem Kallewaard, Harold Nijhuis, Liong Liem, Jan Vesper, Marie E. Fahey*, Bram Blomme, Matthias H. Morgalla, Timothy R. Deer, Robyn A. Capobianco

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

IntroductionSince it became available in the mid-2010s, dorsal root ganglion (DRG) stimulation has become part of the armamentarium to treat chronic pain. To date, one randomized controlled trial, and several studies of moderate sample size and various etiologies have been published on this topic. We conducted a pooled analysis to investigate the generalizability of individual studies and to identify differences in outcome between chronic pain etiologic subgroups and/or pain location.

Materials and MethodsOne prospective, randomized comparative trial and six prospective, single-arm, observational studies were identified that met pre-defined acceptance criteria. Pain scores and patient-reported outcome (PRO) measures were weighted by study sample sizes and pooled. Safety data are reported in aggregate form.

ResultsOur analysis included 217 patients with a permanent implant at 12-month follow-up. Analysis of pooled data showed an overall weighted mean pain score of 3.4, with 63% of patients reporting >= 50% pain relief. Effectiveness sub-analyses in CRPS-I, causalgia, and back pain resulted in a mean reduction in pain intensity of 4.9, 4.6, and 3.9 points, respectively. Our pooled analysis showed a pain score for primary affected region ranging from 1.7 (groin) to 3.0 (buttocks) and responder rates of 80% for foot and groin, 75% for leg, and 70% for back. A substantial improvement in all PROs was observed at 12months. The most commonly reported procedural or device complications were pain at the IPG pocket site, lead fracture, lead migration, and infection.

ConclusionsDRG stimulation is an effective and safe therapy for various etiologies of chronic pain.

Original languageEnglish
Pages (from-to)213-221
Number of pages9
JournalNeuromodulation
Volume23
Issue number2
Early online date15 Nov 2019
DOIs
Publication statusPublished - Feb 2020

Keywords

  • Causalgia
  • complex regional pain syndrome type I
  • dorsal root ganglion stimulation
  • failed back surgery syndrome
  • pooled analysis
  • CLINICALLY IMPORTANT DIFFERENCE
  • CHRONIC NEUROPATHIC PAIN
  • SPINAL-CORD STIMULATION
  • RESEARCH DESIGN CONSIDERATIONS
  • LOW-BACK-PAIN
  • SINGLE-CENTER
  • GROIN PAIN
  • OUTCOMES
  • NEURONS
  • INJURY

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