Stimulation of Dorsal Root Ganglia for the Management of Complex Regional Pain Syndrome: A Prospective Case Series

Pain Practice ◽  
2014 ◽  
Vol 15 (3) ◽  
pp. 208-216 ◽  
Author(s):  
Jean-Pierre Van Buyten ◽  
Iris Smet ◽  
Liong Liem ◽  
Marc Russo ◽  
Frank Huygen
2016 ◽  
Vol 33 ◽  
pp. 192-197 ◽  
Author(s):  
Ilknur Albayrak ◽  
Seza Apiliogullari ◽  
Ozkan Onal ◽  
Cengizhan Gungor ◽  
Ali Saltali; ◽  
...  

Pain Medicine ◽  
2015 ◽  
Vol 16 (7) ◽  
pp. 1369-1372 ◽  
Author(s):  
Seza Apiliogullari ◽  
Bahattin Kerem Aydin ◽  
Ozkan Onal ◽  
Yunus Kirac ◽  
Jale Bengi Celik

2019 ◽  
pp. 185-189
Author(s):  
Loren S. Guzman

Dorsal root ganglion (DRG) stimulation is an effective treatment for chronic, refractory complex regional pain syndrome (CRPS). Routinely, the placement of a DRG stimulator lead is based on established anatomical knowledge of dermatomes. In patients with lumbosacral transitional vertebral anatomy, dermatome maps are not dependable due to dermatomal variance. This can make correct placement of stimulator leads challenging as the supposed target may not actually be responsible for sensing the painful area. We present a case of a 60-year-old woman with CRPS and lumbarization of the S1 vertebral body (presence of 6 lumbar vertebrae and 4 sacral vertebrae) who failed a DRG stimulator trial after using conventional dermatome maps to identify target DRGs assuming that the nerve exiting below L6 corresponded to the S1 dermatome. Following the failed trial, sensory stimulation of the DRG via radiofrequency stimulation was used to accurately map dermatomes leading to a successful DRG stimulation implant at a DRG level that differed from expected based on traditional dermatome maps. Thus, DRG stimulation may guide decisionmaking in regard to target stimulation in patients with abnormal vertebral anatomy. Key words: Dorsal root ganglion stimulation, dermatome mapping, radiofrequency stimulation, spinal anomaly, lumbosacral transitional vertebrae, complex regional pain syndrome, neuromodulation, dermatomal variance


2021 ◽  
Author(s):  
Huimin Nie ◽  
Boyu Liu ◽  
Chengyu Yin ◽  
Ruixiang Chen ◽  
Jie Wang ◽  
...  

Abstract Background: Mirror-image pain (MIP), which develops from the healthy body region contralateral to the actual injured site, is a mysterious pain phenomenon accompanying many chronic pain conditions, including complex regional pain syndrome (CRPS). However, the pathogenesis of MIP still remained largely unknown. The purpose of this study is to perform an expression profiling to identify genes related with MIP in an animal model of CRPS-I. Methods: We established a rat chronic post-ischemic pain (CPIP) model to mimic human CRPS-I. RNA-sequencing (RNA-Seq), bioinformatics, qPCR, immunostaining and animal behavioral assays were used to screen potential genes in contralateral dorsal root ganglia (DRG) that may be involved in MIP. Results: The CPIP model rats developed robust and persistent MIP in contralateral hind paws. Bilateral DRG neurons did not exhibit obvious neuronal damage. RNA-Seq of contralateral DRG from CPIP model rats identified a total 527 differentially expressed genes (DEGs) vs. control rats. The expression changes of several representative DEGs were verified by qPCR. Bioinformatics analysis indicated that immune system process, innate immune response and cell adhesion were among the mostly enriched biological processes, which are all important processes involved in pain sensitization, neuroinflammation and chronic pain. We further identified DEGs potentially involved in pain mechanisms or enriched in small- to medium-sized sensory neurons or TRPV1-lineage nociceptors. By comparing with published datasets summarizing genes enriched in pain mechanisms, we sorted out a core set of genes which might contribute to nociception and pain mechanism in MIP. Conclusions: We provided by far the first study to profile gene expression changes and pathway analysis of contralateral DRG for investigating MIP mechanisms. This work may provide novel insights into understanding the mysterious mechanisms underlying MIP.


2019 ◽  
Vol Volume 12 ◽  
pp. 1201-1216 ◽  
Author(s):  
Chengyu Yin ◽  
Qimiao Hu ◽  
Boyu Liu ◽  
Yan Tai ◽  
Xiaoli Zheng ◽  
...  

2018 ◽  
Vol 128 (3) ◽  
pp. 220-226 ◽  
Author(s):  
Candace M. Waters ◽  
Sandra Ho ◽  
Adam Luginbuhl ◽  
Joseph M. Curry ◽  
David M. Cognetti

Objectives: (1) To define patient demographics and common symptoms in patients who undergo styloidectomy for stylohyoid pain syndrome (Eagle’s syndrome). (2) To evaluate the effectiveness of styloidectomy in reducing symptoms of Eagle’s syndrome. Methods: Retrospective chart review and prospective case series. We retrospectively gathered demographic data on all patients at a single institution who underwent styloidectomy during a 5-year period. Using a patient symptom survey, we also gathered prospective data on a cohort of these patients presenting during the second half of the timeframe. Results: Thirty-two patients underwent styloidectomy for Eagle’s syndrome between November 2010 and June 2015. Of these patients, 22 (68.8%) were female, 29 (90.6%) were Caucasian, and 10 (31.3%) reported history of tonsillectomy. Mean age was 46.0 years, and mean BMI was 26.1 kg/m2. Nineteen patients completed the prospective survey. Average styloid length was 45.3 mm. Most severe preoperative symptoms were neck pain, otalgia, globus, facial pain, headache, and discomfort with neck turning. Thirteen of 17 individual symptoms demonstrated significant decrease in symptom scores after styloidectomy. Aggregate symptom scores also showed significant decrease postsurgically. Longer styloid length correlated with increased scores for dysphagia and odynophagia but not with conglomerate symptom scores. Conclusions: Patients with Eagle’s syndrome were mostly female, Caucasian, and had near-normal BMI. There is wide variability in presenting symptoms of Eagle’s syndrome, but nearly all demonstrate improvement after styloidectomy. Thus, in appropriately selected patients, styloidectomy can effectively and reliably produce improvement in patient symptoms.


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