Neurolysis of the dorsal root ganglion as an alternative in the treatment of postherpetic neuralgia. Case report

2020 ◽  
Vol 3 ◽  
Author(s):  
Nathália B Silva ◽  
Carlos M Barros ◽  
Mayra M Reis ◽  
Rafael Clemente
Keyword(s):  
Case Report ◽  
Dorsal Root Ganglion ◽  
Postherpetic Neuralgia ◽  
Dorsal Root

scholarly journals Dorsal root ganglion stimulation combined with spinal cord stimulation for effective treatment of postherpetic neuralgia - A case report -

2021 ◽  
Author(s):  
Seung Wan Hong ◽  
Min Jung Kim ◽  
Cheol Hwan Park ◽  
Sarah Park ◽  
Jae Hun Kim
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Dorsal Root Ganglion ◽  
Effective Treatment ◽  
Treatment Option ◽  
Postherpetic Neuralgia ◽  
Spinal Cord Stimulation ◽  
Dorsal Root ◽  
Pain Site ◽  
Good Treatment Option

Background: Although spinal cord stimulation (SCS) can be a treatment option for intractable postherpetic neuralgia (PHN), obtaining proper stimulation at the thoracic dermatome is difficult. Dorsal root ganglion (DRG) stimulation may be an effective treatment for patients with insufficient efficacy in SCS only.Case: A 54-year-old man with intractable PHN was referred to our clinic. Pain was localized to the distribution of the T1–3 dermatomes. SCS trial was conducted, and lead was placed within the epidural space over the C6–T1 level; however, the stimulation was inadequate for his pain site. Therefore, another lead was placed within the left T1 and T2 DRG for trial, and T1 DRG stimulation provided adequate stimulation. T1 DRG stimulation and SCS could cover the entire pain site with paresthesia, and his pain was decreased by over 50%.Conclusions: DRG stimulation combined with SCS may be a good treatment option for intractable thoracic PHN.

scholarly journals Evaluation of the Efficacy of Unipolar and Bipolar Spinal Dorsal Root Ganglion Radiofrequency Thermocoagulation in the Treatment of Postherpetic Neuralgia: a Retrospective Study

2020 ◽  
Author(s):  
Jianjun Zhu ◽  
Keyue Xie ◽  
Songlei Liu ◽  
Qiuli He ◽  
Ge Luo ◽  
...  
Keyword(s):  
Dorsal Root Ganglion ◽  
Postherpetic Neuralgia ◽  
Dorsal Root ◽  
Effective Rate ◽  
Group Comparison ◽  
Time Points ◽  
Spinal Dorsal ◽  
Radiofrequency Thermocoagulation ◽  
Surgical Methods

Abstract Background: At present, different views have been proposed on the radiofrequency treatment modes and parameters of radiofrequency thermocoagulation of the spinal dorsal root ganglion for the treatment of postherpetic neuralgia. It is urgent to identify a novel and more effective radiofrequency therapy for patients with postherpetic neuralgia. Methods: A total of 60 patients who underwent radiofrequency thermocoagulation therapy for postherpetic neuralgia in the pain department of our Hospital were retrospectively reviewed from January 2013 to November 2017. According to the different surgical methods, the patients were divided into the following groups: unipolar group (CRF) and bipolar group (DCRF). Subsequently, the pain scores (NRS) were evaluated at the following specific time points: before the operation, on the 1st day after the operation, in 3 and 6 months after the operation and in 1 and 2 years after the operation. Moreover, the incidence of intraoperative and postoperative complications and the degree of pain relief were evaluated in order to assess the efficacy and prognosis of radiofrequency thermocoagulation in the two groups. The in vitro ovalbumin experiment was used to indicate the effects of unipolar and bipolar radiofrequency thermocoagulation.Results: In this study, the intra-group comparison indicated that compared with the preoperative NRS, the postoperative NRS decreased significantly; the inter-group comparison demonstrated that the NRS of the DCRF group was lower than that of the CRF group at all time points from 6 months to 2 years following the operation. The total effective rate of the DCRF group was significantly higher than that of the CRF group in 2 years following the operation. The incidence of numbness in the DCRF group was higher than that noted in the CRF group at each time point following the operation. The ovalbumin experiments in vitro indicated that the effects of radiofrequency thermocoagulation were optimal when the distance between the two needles was 5 mm.Conclusion: Bipolar spinal root ganglion radiofrequency thermocoagulation exhibits a longer duration and higher effective rate in the treatment of postherpetic neuralgia and it’s a treatment method worth promoting.

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.

scholarly journals Two Cases of Dorsal Root Ganglion Stimulation for the Treatment of Postherpetic Neuralgia

2020 ◽  
pp. 179-182
Author(s):  
Chong Kim
Keyword(s):  
Spinal Cord ◽  
Dorsal Root Ganglion ◽  
Postherpetic Neuralgia ◽  
Spinal Cord Stimulation ◽  
Dorsal Root ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Intractable Pain ◽  
Thoracic Level ◽  
Significant Burden

Background: Postherpetic neuralgia (PHN) is the most common long-term complication of shingles and is a significant burden to the patients due to pain and disability. Currently, treatment options are limited. In refractory cases, neuromodulation using spinal cord stimulation (SCS) and peripheral nerve stimulation (PNS) have been used but is considered experimental due to limited evidence. Dorsal root ganglion (DRG) stimulation has been most studied in complex regional pain syndrome and uses electrical leads that are inserted into the epidural space and placed into the intervertebral foramen to target the DRG. Due to the advantages on targeting the DRG, DRG stimulation has been used and can be considered to treat other refractory, intractable pain conditions. Case Report: We report 2 cases who experienced successful treatment of refractory PHN. Patients underwent dorsal root ganglion stimulation at the thoracic level for the treatment of refractory PHN. Both patients showed significant improvement in pain at 24 and 36 months after a DRG stimulation trial and implantation. Conclusion: We report the successful use of DRG stimulation for the treatment of PHN. Key words: Dorsal root ganglion stimulation, neuralgia, neuromodulation, postherpetic neuralgia, spinal cord stimulation

Dorsal root ganglion stimulation for the treatment of severe intractable pain related to obturator nerve entrapment neuropathy: A case report

2020 ◽  
Vol 198 ◽  
pp. 106138 ◽  
Author(s):  
Reda Tolba ◽  
Alvah Tyson Wickboldt ◽  
Ashley Peairs ◽  
Hossam Eldin Mohamed ◽  
Myles Storey ◽  
...  
Keyword(s):  
Case Report ◽  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Obturator Nerve ◽  
Nerve Entrapment ◽  
Entrapment Neuropathy ◽  
Intractable Pain
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