We have considered previously the effectiveness of a form of neuromodulation called Dorsal Root Ganglion Stimulation (DRG) for chronic pain, particularly in the long-term management of CRPS. Indeed, in our last article on this subject, we considered whether DRG was ultimately set to replace the more common Spinal Cord Stimulation (SCS) altogether. This is despite improvements in SCS technology, particularly with newer high-frequency devices now becoming more widely available.
We highlighted the impressive results of one of the few clinical trials of DRG, which mostly involved people suffering CRPS. It was found that at one year following implantation, 74% of participants reported greater than 50% pain relief and one third reported pain relief of 80% or more.
While very encouraging, DRG remains relatively ‘new’ technology. As such, overall there remains comparitavely little published research on its efficacy.
Recently, an international team led by researchers at Erasmus University in Rotterdam, have published a pooled analysis of the studies that are available worldwide on the efficacy of DRG in the management of a number of chronic pain conditions. Despite its wide reach, the authors were still only able to identify results for 217 patients meeting their criteria of having a permanent implant in situ at the time of their twelve month follow-up.
Nevertheless, analysis of this pooled data was again encouraging. Among other findings were:
- “an overall weighted mean pain score of 3.4”;
- “63% of patients reporting [50% or more] pain relief”;
- for those suffering CRPS 1, CRPS 2 and back pain the “mean reduction in pain intensity [was] 4.9, 4.6, and 3.9 points [out of 10], respectively”;
- a substantial improvement in all patient-reported outcomes (PROs) was observed at 12 months.
It was found that the “most commonly reported procedural or device complications were pain at the [implant] pocket site, lead fracture, lead migration, and infection.”
Despite these complications, the study concluded that “DRG stimulation is an effective and safe therapy for various etiologies of chronic pain.”