Jan Willem Kallewaard1, Harold Nijhuis2, Frank Huygen3, Frank Wille4,5, Xander Zuidema4,5, Johan van de Minkelis6, Adil Raza7. 1. Rijnstate Ziekenhuis, Velp, The Netherlands. 2. St. Antonius Hospital, Nieuwegein, The Netherlands. 3. Erasmus University, Rotterdam, The Netherlands. 4. Diakonessenhuis Utrecht, Zeist, The Netherlands. 5. Academic Medical Centre Amsterdam, Amsterdam, The Netherlands. 6. Elisabeth-Tweesteden Ziekenhuis, Tilburg, The Netherlands. 7. Abbott Laboratories, Plano, Texas, U.S.A.
Abstract
INTRODUCTION: Surgical lumbar discectomy is a commonly performed routine spinal procedure that is usually undertaken to alleviate lumbar radicular symptoms caused by a herniated intervertebral disc. Surgical lumbar discectomy can also lead to chronic postsurgical leg and/or back pain (failed back surgery syndrome [FBSS]), a condition that can be refractory to conventional medical management. Early clinical results on the use of dorsal root ganglion (DRG) stimulation for FBSS have supported the use of this treatment alternative. METHODS: A multicenter, single-arm, observational cohort study enrolled patients who had chronic pain following surgical lumbar discectomy, had failed conservative treatments, and reported pain intensity of at least 6 out of 10 in the primary region of pain. Data were collected on pain, quality of life, disability, and mood at baseline and through 12 months. RESULTS: Thirteen patients underwent a trial of DRG stimulation; 11 (84.6%; 95% confidence interval = 57.8% to 95.7%) had good outcomes and underwent permanent device placement. Pain was reduced from a score of 8.64 (±0.92) at baseline to 2.40 (±2.38; n = 9) after 12 months of treatment, a 72.05% average reduction (P < 0.001). Similar improvements were observed across the secondary clinical measures, and safety data were in line with published rates. DISCUSSION: These results suggest that DRG stimulation induces pain relief in subjects diagnosed with FBSS. These reductions in pain were also associated with improvements in quality of life and disability. Additional prospective studies are warranted to further investigate this potential application of DRG stimulation, as well as to optimize patient selection, lead placement, and programming strategies.
INTRODUCTION: Surgical lumbar discectomy is a commonly performed routine spinal procedure that is usually undertaken to alleviate lumbar radicular symptoms caused by a herniated intervertebral disc. Surgical lumbar discectomy can also lead to chronic postsurgical leg and/or back pain (failed back surgery syndrome [FBSS]), a condition that can be refractory to conventional medical management. Early clinical results on the use of dorsal root ganglion (DRG) stimulation for FBSS have supported the use of this treatment alternative. METHODS: A multicenter, single-arm, observational cohort study enrolled patients who had chronic pain following surgical lumbar discectomy, had failed conservative treatments, and reported pain intensity of at least 6 out of 10 in the primary region of pain. Data were collected on pain, quality of life, disability, and mood at baseline and through 12 months. RESULTS: Thirteen patients underwent a trial of DRG stimulation; 11 (84.6%; 95% confidence interval = 57.8% to 95.7%) had good outcomes and underwent permanent device placement. Pain was reduced from a score of 8.64 (±0.92) at baseline to 2.40 (±2.38; n = 9) after 12 months of treatment, a 72.05% average reduction (P < 0.001). Similar improvements were observed across the secondary clinical measures, and safety data were in line with published rates. DISCUSSION: These results suggest that DRG stimulation induces pain relief in subjects diagnosed with FBSS. These reductions in pain were also associated with improvements in quality of life and disability. Additional prospective studies are warranted to further investigate this potential application of DRG stimulation, as well as to optimize patient selection, lead placement, and programming strategies.
Authors: Dongman Chao; Christina M Mecca; Guoliang Yu; Ian Segel; Michael S Gold; Quinn H Hogan; Bin Pan Journal: Pain Date: 2021-12-01 Impact factor: 6.961
Authors: Frank J P M Huygen; Jan Willem Kallewaard; Harold Nijhuis; Liong Liem; Jan Vesper; Marie E Fahey; Bram Blomme; Matthias H Morgalla; Timothy R Deer; Robyn A Capobianco Journal: Neuromodulation Date: 2019-11-15
Authors: Amnon A Berger; Yao Liu; HarLee Possoit; Anna C Rogers; Warner Moore; Kyle Gress; Elyse M Cornett; Alan David Kaye; Farnad Imani; Kambiz Sadegi; Giustino Varrassi; Omar Viswanath; Ivan Urits Journal: Anesth Pain Med Date: 2021-03-28