Dorsal root ganglion stimulation vs. conventional spinal cord stimulation - efficacy and patient experience of two neurostimulation methods for the treatment of Complex Regional Pain Syndrome type II: A case report

Tomasz Bendinger

Abstract


Objectives:

To compare the effectiveness and patient experience of conventional spinal cord stimulation vs. dorsal root ganglion stimulation as treatment modalities for Complex Regional Pain Syndrome (CRPS) type II.

Material and methods:

A 39-year-old woman with CRPS type II of the right foot, diagnosed according to Budapest Criteria, received conventional Spinal Cord Stimulation (SCS) after unsuccessful conventional medical therapy. Due to a lack of effectiveness of conventional SCS, as a consequence of lead migration and positional changes of stimulation induced paraesthesia, nine months post implantation the patient was considered for revision of SCS lead. Dorsal Root Ganglion (DRG) was chosen due to growing evidence of non-inferiority over conventional SCS for patients with distal extremities pain, with reduced incidence of lead migration.

Results: After trial of stimulation, with a single right L5 DRG lead, which provided substantial pain relief and excellent topographical coverage, a permanent implantable pulse generator (IPG) was implanted. Three and six months after implantation, the patient experienced 80-90% pain relief and significant improvement of foot function. Patient overall impression of improvement was much higher after DRG stimulation, which was more tolerable and less positional in its effect compared with conventional SCS.

Conclusion: Placement of DRG stimulation provided better relief and higher patient overall impression of improvement than conventional SCS. There is a need for more direct comparisons of different types of neuromodulation techniques.


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