Effectiveness of combined dorsal root ganglion and spinal cord stimulation: a retrospective, single-centre case series for chronic focal neuropathic pain.

Autor:	Mullins CF; Pain Management Department, Gassiot House, Guy's and St. Thomas' NHS Foundation Trust, London SE1 7EH, United Kingdom.; Department of Pain Medicine, South Infirmary Victoria University Hospital, Cork T12X23H, Ireland., Palumbo GJ; Pain Management Department, Gassiot House, Guy's and St. Thomas' NHS Foundation Trust, London SE1 7EH, United Kingdom., Harris S; Pain Management Department, Gassiot House, Guy's and St. Thomas' NHS Foundation Trust, London SE1 7EH, United Kingdom., Al-Kaisy O; Pain Management Department, Gassiot House, Guy's and St. Thomas' NHS Foundation Trust, London SE1 7EH, United Kingdom., Wesley S; Pain Management Department, Gassiot House, Guy's and St. Thomas' NHS Foundation Trust, London SE1 7EH, United Kingdom., Yearwood T; Pain Management Department, Gassiot House, Guy's and St. Thomas' NHS Foundation Trust, London SE1 7EH, United Kingdom., Al-Kaisy A; Pain Management Department, Gassiot House, Guy's and St. Thomas' NHS Foundation Trust, London SE1 7EH, United Kingdom.
Jazyk:	angličtina
Zdroj:	Pain medicine (Malden, Mass.) [Pain Med] 2024 Feb 01; Vol. 25 (2), pp. 116-124.
DOI:	10.1093/pm/pnad128
Abstrakt:	Objective: This case series retrospectively reviewed the outcomes in patients implanted with combined, synchronous dorsal root ganglion stimulation (DRGS) and spinal cord stimulation (SCS) connected to a single implantable pulse generator (IPG) in a tertiary referral neuromodulation centre in the United Kingdom. Methods: Twenty-six patients underwent a trial of DRGS+SCS for treating focal neuropathic pain between January 2016 and December 2019, with a follow-up in February 2022. A Transgrade approach was employed for DRGS. Patients were provided with 3 possible stimulation programs: DRGS-only, SCS-only, or DRGS+SCS. Patients were assessed for pain intensity, patients' global impression of change (PGIC), preferred lead(s) and complications. Results: Twenty patients were successful and went on for full implantation. The most common diagnosis was Complex Regional Pain Syndrome. After an average of 3.1 years follow-up, 1 patient was lost to follow-up, and 2 were non-responders. Of the remaining 17 patients, 16 (94%) continued to report a PGIC of 7. The average pain intensity at Baseline was 8.5 on an NRS scale of 0-10. At the last follow-up, the average NRS reduction overall was 78.9% with no statistical difference between those preferring DRGS+SCS (n = 9), SCS-only (n = 3) and DRGS-only (n = 5). The combination of DRGS+SCS was preferred by 53% at the last follow-up. There were no serious neurological complications. Conclusions: This retrospective case series demonstrates the potential effectiveness of combined DRGS+SCS with sustained analgesia observed at an average follow-up of over 3 years. Implanting combined DRGS+SCS may provide programming flexibility and therapeutic alternatives. (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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