scholarly journals Dorsal Root Ganglion Stimulation as Treatment for Complex Regional Pain Syndrome of the Foot Refractory to Spinal Cord Stimulation: A Case Report

Cureus ◽  
2021 ◽  
Author(s):  
Kailash Pendem ◽  
Navdeep Jassal
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Dorsal Root Ganglion ◽  
Complex Regional Pain Syndrome ◽  
Spinal Cord Stimulation ◽  
Dorsal Root ◽  
Pain Syndrome

scholarly journals Dorsal root ganglion stimulation for treatment of complex regional pain syndrome of the foot

2020 ◽  
Vol 3 (2) ◽  
pp. V8
Author(s):  
Kevin Hines ◽  
Fadi Al Saiegh ◽  
Aria Mahtabfar ◽  
Kavantissa M. Keppetipola ◽  
Caio M. Matias ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Dorsal Root Ganglion ◽  
Complex Regional Pain Syndrome ◽  
Spinal Cord Stimulation ◽  
Dorsal Root ◽  
Pain Syndrome ◽  
Thoracic Spinal Cord ◽  
Plantar Aspect ◽  
Thoracic Spinal ◽  
The Right

This is a case of a 54-year-old man presenting with complex regional pain syndrome (CRPS) type 1 of the right lower extremity, which was most debilitating in the plantar aspect of the right foot. The patient had prior treatment with thoracic spinal cord stimulation; however, the foot pain remained intractable. Given that his pain was predominantly in his foot and remained debilitating despite thoracic spinal cord stimulation, it was recommended that the patient undergo a trial of dorsal root ganglion (DRG) stimulation. The surgical technique for placement of dorsal root ganglion stimulators is demonstrated in this operative video.The video can be found here: https://youtu.be/_1xMxFZa6tU

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

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 Spinal cord stimulation for complex regional pain syndrome type 1 with dystonia: a case report and discussion of the literature

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 97 ◽  
Author(s):  
Caroline Voet ◽  
Bernard le Polain de Waroux ◽  
Patrice Forget ◽  
Ronald Deumens ◽  
Etienne Masquelier
Keyword(s):  
Spinal Cord ◽  
Nervous System ◽  
Case Report ◽  
Complex Regional Pain Syndrome ◽  
Spinal Cord Stimulation ◽  
Behavioural Change ◽  
Pain Syndrome ◽  
Social Model ◽  
Syndrome Type

Background: Complex Regional Pain Syndrome type 1 (CRPS-1) is a debilitating chronic pain disorder, the physiopathology of which can lead to dystonia associated with changes in the autonomic, central and peripheral nervous system. An interdisciplinary approach (pharmacological, interventional and psychological therapies in conjunction with a rehabilitation pathway) is central to progress towards pain reduction and restoration of function.Aim: This case report aims to stimulate reflection and development of mechanism-based therapeutic strategies concerning CRPS associated with dystonia.Case description: A 31 year old female CRPS-1 patient presented with dystonia of the right foot following ligamentoplasty for chronic ankle instability. She did not have a satisfactory response to the usual therapies. Multiple anesthetic blocks (popliteal, epidural and intrathecal) were not associated with significant anesthesia and analgesia. Mobilization of the foot by a physiotherapist was not possible. A multidisciplinary approach with psychological support, physiotherapy and spinal cord stimulation (SCS) brought pain relief, rehabilitation and improvement in the quality of life.Conclusion: The present case report demonstrates the occurrence of multilevel (peripheral and central) pathological modifications in the nervous system of a CRPS-1 patient with dystonia. This conclusion is based on the patient’s pain being resistant to anesthetic blocks at different levels and the favourable, at least initially, response to SCS. The importance of the bio-psycho-social model is also suggested, permitting behavioural change.

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

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