Efficacy and safety of dorsal root ganglion stimulation as treatment for neuropathic pain: bibliographic review.

International society of neurosurgery pain

OBJECTIVE: Dorsal root ganglion stimulation (DRGS) received its first regulatory approval (CE marked in Europe) in late 2011, so it has been used for nearly seven years. Several thousand patients have now been treated, and recently an historic test has been published on its use in type I and II complex regional pain syndromes (CRPS).

METHODS: In this review we have summarised the literature to date on the use of DRG in the treatment of neuropathic pain.

RESULTS: The results to date are encouraging, with reports of successful use in the treatment of a wide range of indications including post-surgical pain, CRPS and phantom pain. The treatment of failed back surgery syndrome (FBSS) seems to be less satisfactory. The therapy is still recent and long-term results are not yet available. There is currently good evidence from randomised clinical trials (RCT) demonstrating that DRGS provides a greater pain relief than medullary stimulation (MS) in patients with type I and II CRPS of the lower limbs, and produces a stimulation with reater postural stability and more precise coverage of the paraesthesia. However, there is a lack of tests of this quality for other pain indications and locations.

CONCLUSION: There is currently evidence of Class A RCT that DRGS provides a greater pain relief than MS for type I and II CRPS of the lower limbs. In the coming years we hope that randomised controlled tests are conducted indication by indication so that, together with the publication of long-term follow-up data, a more complete understanding of the role of the DRG in the treatment of neuropathic pain can be reached.

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