The Efficacy and Safety of Dorsal Root Ganglion Stimulation as a Treatment for Neuropathic Pain: A Literature Review
Harrison C., Epton S., Bojanic S., Green AL., Fitzgerald JJ.
Introduction: Dorsal root ganglion stimulation (DRGS) received its first regulatory approval (CE marking in Europe) in late 2011, and so its use is now just over six years old. Several thousand patients have already been treated, and a landmark trial in lower limb CRPS and causalgia has recently been published. Methods: In this review we have summarised the literature to date on the use of DRGS in the treatment of neuropathic pain. Results: The results so far are encouraging, with reports of successful use in treating a wide range of indications including postsurgical pain, CRPS, and phantom pain. Treatment of failed back surgery syndrome (FBSS) appears less successful. The therapy is still young, and long term results are not yet available. There is now good RCT evidence that DRGS provides superior pain relief to spinal cord stimulation for CRPS and causalgia of the lower limb, and produces stimulation that is more posturally stable, with more precise paraesthesia coverage. However evidence of this quality for other indications and pain locations is lacking. Conclusion: There is now Class A RCT evidence that DRGS provides superior pain relief to SCS for CRPS and causalgia of the lower limb. In the coming years we hope that randomised controlled trials will be performed on an indication-by-indication basis, which, together with the publication of longer term follow up data, will provide a more complete understanding of the role of DRGS in the treatment of neuropathic pain syndromes.