Dorsal Root Ganglion Size in Patients With Complex Regional Pain Syndrome of the Lower Extremity: A Retrospective Pilot Study.

Autor: Vargas AJ; Arkansas College of Osteopathic Medicine, Fort Smith, AR, USA., Elkhateb R; Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA., Tobey-Moore L; Department of Psychiatry, Center for Health Services Research, University of Arkansas for Medical Sciences, Little Rock, AR, USA., Van Hemert RL; Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA., Fuccello A; Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA., Goree JH; Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA. Electronic address: jhgoree@uams.edu.
Jazyk: angličtina
Zdroj: Neuromodulation : journal of the International Neuromodulation Society [Neuromodulation] 2024 Dec; Vol. 27 (8), pp. 1435-1440. Date of Electronic Publication: 2024 Sep 04.
DOI: 10.1016/j.neurom.2024.07.006
Abstrakt: Objective: Complex regional pain syndrome (CRPS) is a debilitating chronic condition characterized by severe, nociplastic pain along with various other symptoms. Neuromodulation, particularly electrical stimulation of the dorsal root ganglion (DRG), has emerged as a promising intervention for patients with CRPS unresponsive to conventional treatments. However, little is known about the anatomical characteristics of DRGs in patients with CRPS. This study aimed to assess DRG size in patients with CRPS compared with healthy controls.
Materials and Methods: A retrospective pilot study was conducted in 12 patients with unilateral lower extremity CRPS who have a history of lumbar magnetic resonance imaging, and evaluated DRG sizes bilaterally. Patients were age-, race-, and sex-matched to patients in the control group who were asymptomatic at matched spinal level. DRG sizes were evaluated by a neuroradiologist. Statistical analyses including paired t-tests were performed to compare the difference in DRG size in contralateral sides in patients with CRPS and their matched controls.
Results: Patients with CRPS exhibited a statistically significant reduction in DRG size on the affected side compared with the unaffected side (4.4 mm-4.8 mm, respectively). This difference was significant when compared with the difference observed in healthy controls (4.9 mm-5.0 mm, respectively). In addition, the mean DRG size difference between the affected and unaffected side showed a greater difference in DRG size in patients with CRPS (0.6 mm difference) than in control patients (0.2 mm difference).
Conclusions: The findings suggest that CRPS is associated with a smaller DRG size in affected dermatomes, potentially indicating neuronal atrophy. Importantly, the study offers insights for DRG stimulation therapy especially among concerns for DRG compression after placement. This pilot study reveals a significant size difference in DRGs between affected and unaffected sides in patients with CRPS compared with controls, highlighting potential implications for treating CRPS. Further research is warranted to validate these findings and explore implications for clinical practice, including optimized neuromodulation strategies.
Competing Interests: Conflict of Interest Johnathan H. Goree has consulting agreements with Abbott, Saluda, and Stratus Medical, and also has funded research paid to his institution from SPR Therapeutics and Mainstay Medical. The remaining authors report no conflict of interest.
(Copyright © 2024 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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