Skip to main content

Advertisement

SpringerLink
Log in

Synergetic efficacy of simultaneous DRG- and traditional spinal cord stimulation

  • Original Article - Functional Neurosurgery - Pain
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

Dorsal root ganglion stimulation has established its role in chronic pain states and is commonly used as an alternative treatment to traditional spinal cord stimulation. Due to its approach, DRG stimulation is preferably used in pain conditions affecting a small area or a distinct nerve root. In selected patients, a combination of both techniques might be useful.

Methods

We report a series of five patients with chronic pain treated with DRG stimulation and traditional spinal cord stimulation from 2011 to 2018. Pain was reported on the VAS scale at the baseline, before and 12 months after the second procedure.

Results

All patients suffered from back and lower limb pain, four with a FBSS syndrome, one with CRPS. In all but one patient, SCS was implanted first and complemented with a DRG in the course (4–90 months between procedures). An additional stimulation system was implanted because the previous stimulation failed to reach the pain area or because the patient had an altered perception of other pain component after stimulation. All but one patient had a consistent and satisfying therapeutic effect with both systems activated.

Conclusion

The combination of dorsal root ganglion and traditional spinal cord stimulation is surgically and technically feasible. In selected patients, the combination of both methods offers an option to alleviate pain states not sufficiently or not efficiently treated with one method alone. The introduction of IPGs combining SCS and DRG stimulation paradigms might be useful to increase acceptance of this option.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Deer TR, Levy RM, Kramer J, et al (2019) Comparison of Paresthesia coverage of Patient’s pain: dorsal root ganglion vs. spinal cord stimulation. An ACCURATE Study Sub-Analysis. Neuromodulation

  2. Jang H-D, Kim M-S, Chang C-H et al (2008) Analysis of failed spinal cord stimulation trials in the treatment of intractable chronic pain. J Korean Neurosurg Soc 43:85–89

    Article  Google Scholar 

  3. Morales A, Yong RJ, Kaye AD, Urman RD (2019) Spinal cord stimulation: comparing traditional low-frequency tonic waveforms to novel high frequency and burst stimulation for the treatment of chronic low Back pain. Curr Pain Headache Rep 23:25

    Article  Google Scholar 

  4. Piedade GS, Vesper J, Chatzikalfas A, Slotty PJ (2019) Cervical and high-thoracic dorsal root ganglion stimulation in chronic neuropathic pain. Neuromodulation

  5. Wagner AL (2004) Selective lumbar nerve root blocks with CT fluoroscopic guidance: technique, results, procedure time, and radiation dose. AJNR Am J Neuroradiol 25:1592–1594

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Heinrich-Heine-Universität Düsseldorf, Moorenstraße. 5, 40225, Düsseldorf, Germany

    G. S. Piedade & Philipp J. Slotty

  2. Department of Functional Neurosurgery and Stereotaxy, Heinrich-Heine-Universität Düsseldorf, Moorenstraße. 5, 40225, Düsseldorf, Germany

    J. Vesper & Philipp J. Slotty

Authors
  1. G. S. Piedade
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Vesper
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Philipp J. Slotty
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

PJS and GSP conceived the idea, JV, PJS and GSP performed the procedures and follow-ups, GSP and PJS developed the project, GSP and PJS wrote the manuscript with input from all authors. All authors approved the final version of the manuscript.

Parts of the findings in this paper have been presented at the INS 14th World Congress.

Corresponding author

Correspondence to Philipp J. Slotty.

Ethics declarations

Conflict of interest

PJS and JV received travel expense reimbursement and speaker honoraria from Abbott. All authors certify that they have no financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the ethics committee of the Medical School of the Heinrich-Heine-Universität Düsseldorf and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent was not required.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Functional Neurosurgery - Pain

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Piedade, G.S., Vesper, J. & Slotty, P.J. Synergetic efficacy of simultaneous DRG- and traditional spinal cord stimulation. Acta Neurochir 162, 257–260 (2020). https://doi.org/10.1007/s00701-019-04166-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-019-04166-y

Keywords

Search

Navigation