Observing Altered Nociceptive Detection Thresholds in Patients With Persistent Spinal Pain Syndrome Type 2 With a Dorsal Root Ganglion Stimulator

2022 ◽  
Author(s):  
Tom Berfelo ◽  
Robert-Jan Doll ◽  
Imre Poldino Krabbenbos ◽  
Jan Reinoud Buitenweg
Keyword(s):  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Pain Syndrome ◽  
Spinal Pain ◽  
Syndrome Type ◽  
Detection Thresholds ◽  
Spinal Pain Syndrome

scholarly journals Persistent Spinal Pain Syndrome Type 2 (PSPS-T2), a Social Pain? Advocacy for a Social Gradient of Health Approach to Chronic Pain

2021 ◽  
Vol 10 (13) ◽  
pp. 2817
Author(s):  
Nicolas Naiditch ◽  
Maxime Billot ◽  
Maarten Moens ◽  
Lisa Goudman ◽  
Philippe Cornet ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Syndrome ◽  
Spinal Pain ◽  
Social Gradient ◽  
Syndrome Type ◽  
Multicentric Study ◽  
The Social ◽  
Failed Back Surgery ◽  
Spinal Pain Syndrome

The Social Gradient of Health (SGH), or position in the social hierarchy, is one of the major determinants of health. It influences the development and evolution of many chronic diseases. Chronic pain dramatically affects individual and social condition. Its medico-economic impact is significant and worldwide. Failed Back Surgery Syndrome or Persistent Spinal Pain Syndrome type 2 (PSPS-T2) represents one of its most fascinating and disabling conditions. However, the influence of SGH on PSPS-T2 has been poorly explored. We designed a prospective multicentric study (PREDIBACK study) to assess the SGH prevalence, and to examine its association with medical and psychological variables, in PSPS-T2 patients. This study included 200 patients to determine the SGH association with pain (NPRS), Quality of life (EQ-5D-5L), kinesiophobia (FABQ-Work), catastrophism (CSQ), and functional capacity (ODI). Around 85.3% of PSPS-T2 patients in our study had low SGH. Low SGH patients had a higher FABQ-Work and CSQ-Catastrophizing score than high SGH patients (p < 0.05). High SGH patients have a higher ODI score than low SGH patients (p < 0.10). Our results suggest that SGH is a relevant factor to guide prevention, research, and ultimately intervention in PSPS-T2 patients and could be more widely transposed to chronic pain.

Therapy Habituation at 12 Months: Spinal Cord Stimulation Versus Dorsal Root Ganglion Stimulation for Complex Regional Pain Syndrome Type I and II

2020 ◽  
Vol 21 (3-4) ◽  
pp. 399-408 ◽  
Author(s):  
Robert M. Levy ◽  
Nagy Mekhail ◽  
Jeffrey Kramer ◽  
Lawrence Poree ◽  
Kasra Amirdelfan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Dorsal Root Ganglion ◽  
Complex Regional Pain Syndrome ◽  
Spinal Cord Stimulation ◽  
Dorsal Root ◽  
Pain Syndrome ◽  
Type I ◽  
Syndrome Type

scholarly journals Comparison of Spinal Cord Stimulation vs. Dorsal Root Ganglion Stimulation vs. Association of Both in Patients with Refractory Chronic Back and/or Lower Limb Neuropathic Pain: An International, Prospective, Randomized, Double-Blinded, Crossover Trial (BOOST-DRG Study)

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 7
Author(s):  
Philippe Rigoard ◽  
Manuel Roulaud ◽  
Lisa Goudman ◽  
Nihel Adjali ◽  
Amine Ounajim ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Dorsal Root Ganglion ◽  
Spinal Cord Stimulation ◽  
Dorsal Root ◽  
Functional Disability ◽  
Pain Syndrome ◽  
Spinal Pain ◽  
Assess Quality ◽  
Global Impression Of Change ◽  
Double Blinded

While spinal cord stimulation (SCS) is a well-established therapy to address refractory persistent spinal pain syndrome after spinal surgery (PSPS-T2), its lack of spatial selectivity and reported discomfort due to positional effects can be considered as significant limitations. As alternatives, new waveforms, such as burst stimulation and different spatial neural targets, such as dorsal root ganglion stimulation (DRGS), have shown promising results. Comparisons between DRGS and standard SCS, or their combination, have never been studied on the same patients. “BOOST DRG” is the first prospective, randomized, double-blinded, crossover study to compare SCS vs. DRGS vs. SCS+DRGS. Sixty-six PSPS-T2 patients will be recruited internationally in three centers. Before crossing over, patients will receive each stimulation modality for 1 month, using tonic conventional stimulation. After 3 months, stimulation will consist in switching to burst for 1 month, and patients will choose which modality/waveform they receive and will then be reassessed at 6 and 12 months. In addition to our primary outcome based on pain rating, this study is designed to assess quality of life, functional disability, psychological distress, pain surface coverage, global impression of change, medication quantification, adverse events, brain functional imaging and electroencephalography, with the objective being to provide a multidimensional insight based on composite pain assessment.

Somatostatin Type 2 Receptor Antibody Enhances Mechanical Hyperalgesia in the Dorsal Root Ganglion Neurons after Sciatic Nerve-pinch Injury: Evidence of Behavioral Studies and Bax Protein Expression

2020 ◽  
Vol 18 (10) ◽  
pp. 791-797
Author(s):  
Qiong Xiang ◽  
Jing-Jing Li ◽  
Chun-Yan Li ◽  
Rong-Bo Tian ◽  
Xian-Hui Li
Keyword(s):  
Sciatic Nerve ◽  
Dorsal Root Ganglion ◽  
Nerve Injury ◽  
Dorsal Root ◽  
Underlying Mechanism ◽  
Dorsal Root Ganglion Neurons ◽  
Mechanical Hyperalgesia ◽  
Bax Protein ◽  
Ganglion Neurons

Background: Our previous study has indicated that somatostatin potently inhibits neuropathic pain through the activation of its type 2 receptor (SSTR2) in mouse dorsal root ganglion and spinal cord. However, the underlying mechanism of this activation has not been elucidated clearly Objective: The aim of this study is to perform the pharmacological studies on the basis of sciatic nerve-pinch mice model and explore the underlying mechanism involving SSTR2. Methods: On the basis of a sciatic nerve-pinch injury model, we aimed at comparing the painful behavior and dorsal root ganglion neurons neurochemical changes after the SSTR2 antibody (anti- SSTR2;5μl,1μg/ml) administration in the mouse. Results: After pinch nerve injury, we found that the mechanical hyperalgesia and severely painful behavior (autotomy) were detected after the application of SSTR2 antibody (anti-SSTR2; 5μl, 1μg/ml) on the pinch-injured nerve. The up-regulated phosphorylated ERK (p-ERK) expression and the apoptotic marker (i.e., Bax) were significantly decreased in DRGs after anti-SSTR2 treatment. Conclusion: The current data suggested that inhibitory changes in proteins from the apoptotic pathway in anti-SSTR2-treated groups might be taking place to overcome the protein deficits caused by SSTR2 antibody and supported the new therapeutic intervention with SSTR2 antagonist for neuronal degeneration following nerve injury.

scholarly journals Persistent Spinal Pain Syndrome: a proposal for Failed Back Surgery Syndrome and ICD-11

Pain Medicine ◽  
2021 ◽  
Author(s):  
Nick Christelis ◽  
Brian Simpson ◽  
Marc Russo ◽  
Michael Stanton-Hicks ◽  
Giancarlo Barolat ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Spine Surgery ◽  
Pain Syndrome ◽  
Spinal Pain ◽  
Failed Back Surgery Syndrome ◽  
Medical Professionals ◽  
Failed Back Surgery ◽  
Back Surgery ◽  
Spinal Pain Syndrome

Abstract Objective For many medical professionals dealing with patients with persistent pain following spine surgery, the term failed back surgery syndrome (FBSS) as a diagnostic label is inadequate, misleading and potentially troublesome. It misrepresents causation. Alternative terms have been suggested but none has replaced FBSS. The International Association for the Study of Pain (IASP) published a revised classification of chronic pain, as part of the new International Classification of Diseases (ICD-11), which has been accepted by the World Health Organization (WHO). This includes the term Chronic pain after spinal surgery (CPSS), which is suggested as a replacement for FBSS. Methods This article provides arguments and rationale for a replacement definition. In order to propose a broadly applicable yet more precise and clinically informative term, an international group of experts was established. Results 14 candidate replacement terms were considered and ranked. The application of agreed criteria reduced this to a shortlist of four. A preferred option – Persistent spinal pain syndrome – was selected by a structured workshop and Delphi process. We provide rationale for using Persistent spinal pain syndrome and a schema for its incorporation into ICD-11. We propose the adoption of this term would strengthen the new ICD-11 classification. Conclusions This project is important to those in the fields of pain management, spine surgery and neuromodulation, as well as patients labelled with FBSS. Through a shift in perspective it could facilitate the application of the new ICD-11 classification and allow clearer discussion amongst medical professionals, industry, funding organisations, academia, and the legal profession.

5HT Increases Excitability of Nociceptor-Like Rat Dorsal Root Ganglion Neurons Via cAMP-Coupled TTX-Resistant Na+Channels

2001 ◽  
Vol 86 (1) ◽  
pp. 241-248 ◽  
Author(s):  
Luz M. Cardenas ◽  
Carla G. Cardenas ◽  
Reese S. Scroggs
Keyword(s):  
Dorsal Root Ganglion ◽  
Signaling Pathway ◽  
Dorsal Root ◽  
Phosphodiesterase Inhibitor ◽  
Dorsal Root Ganglion Neurons ◽  
Receptor Coupling ◽  
Low Threshold ◽  
Ganglion Neurons ◽  
Serotonergic Modulation

The physiological effects of 5HT receptor coupling to TTX-resistant Na+ current, and the signaling pathway involved, was studied in a nociceptor-like subpopulation of rat dorsal root ganglion (DRG) cells (type 2), which can be identified by expression of a low-threshold, slowly inactivating A-current. The 5HT-mediated increase in TTX-resistant Na+ current in type 2 DRG cells was mimicked and occluded by 10 μM forskolin. Superfusion of type 2 DRG cells on the outside with 1 mM 8-bromo-cAMP or chlorophenylthio-cAMP (CPT-cAMP) increased the Na+ current, but less than 5HT itself. However, perfusion of the cells inside with 2 mM CPT-cAMP strongly increased the amplitude of control Na+currents and completely occluded the effect of 5HT. Thus it appears that the signaling pathway includes cAMP. The phosphodiesterase inhibitor 3-isobutyl-l-methylxanthine (200 μM) also mimicked the effect of 5HT on Na+ current, suggesting tonic adenylyl cyclase activity. 5HT reduced the amount of current required to evoke action potentials in type 2 DRG cells, suggesting that 5HT may lower the threshold for activation of nociceptor peripheral receptors. The above data suggest that serotonergic modulation of TTX-resistant Na+channels through a cAMP-dependent signaling pathway in nociceptors may participate in the generation of hyperalgesia.

50 challenging spinal pain syndrome cases

2003 ◽  
Vol 8 (4) ◽  
pp. 261
Author(s):  
Sara Luetchford
Keyword(s):  
Pain Syndrome ◽  
Spinal Pain ◽  
Spinal Pain Syndrome

Dorsal root ganglion stimulation lead fractures: potential mechanisms and ways to avoid

2021 ◽  
Vol 14 (5) ◽  
pp. e241353
Author(s):  
Gaurav Chauhan ◽  
Brandon I Roth ◽  
Nagy Mekhail
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Case Report ◽  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Unusual Case ◽  
Pain Syndrome ◽  
Structural Instability ◽  
Probable Mechanism ◽  
Lead Fracture

Dorsal root ganglion stimulation (DRGS) therapy is a rapidly emerging tool being used by pain physicians in the treatment of chronic pain. Complex regional pain syndrome (CRPS), a debilitating disease whose mechanism is still has yet to be fully elucidated, is a common pathology targeted by DRGS therapy, often better results than traditional spinal cord stimulation. DRGS therapy, however, is not bereft of complications. Lead migration and fracture are two examples in particular that are among the most common of these complications. The authors report an unusual case of lost efficacy due to lead fractures in patients with CRPS treated with DRGS. The case report narrates identification, management and probable mechanism of DRGS lead fracture. The structural instability of DRGS leads can yield distressing symptoms at any point during the therapy, and physicians should be cognisant of the complications of DRGS therapy.

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