Open AccessEffectiveness and Safety of Dorsal Root Ganglion Stimulation for the Treatment of Chronic Pain: A Pooled Analysis
Author(s) -
Huygen Frank J.P.M.,
Kallewaard Jan Willem,
Nijhuis Harold,
Liem Liong,
Vesper Jan,
Fahey Marie E.,
Blomme Bram,
Morgalla Matthias H.,
Deer Timothy R.,
Capobianco Robyn A.
Publication year - 2020
Publication title -
neuromodulation: technology at the neural interface
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.296
H-Index - 60
eISSN - 1525-1403
pISSN - 1094-7159
DOI - 10.1111/ner.13074
Subject(s) - medicine , chronic pain , randomized controlled trial , observational study , neuropathic pain , buttocks , physical therapy , anesthesia , surgery
Since it became available in the mid‐2010s, dorsal root ganglion (DRG) stimulation has become part of the armamentarium to treat chronic pain. To date, one randomized controlled trial, and several studies of moderate sample size and various etiologies have been published on this topic. We conducted a pooled analysis to investigate the generalizability of individual studies and to identify differences in outcome between chronic pain etiologic subgroups and/or pain location. Materials and Methods One prospective, randomized comparative trial and six prospective, single‐arm, observational studies were identified that met pre‐defined acceptance criteria. Pain scores and patient‐reported outcome (PRO) measures were weighted by study sample sizes and pooled. Safety data are reported in aggregate form. Results Our analysis included 217 patients with a permanent implant at 12‐month follow‐up. Analysis of pooled data showed an overall weighted mean pain score of 3.4, with 63% of patients reporting ≥50% pain relief. Effectiveness sub‐analyses in CRPS‐I, causalgia, and back pain resulted in a mean reduction in pain intensity of 4.9, 4.6, and 3.9 points, respectively. Our pooled analysis showed a pain score for primary affected region ranging from 1.7 (groin) to 3.0 (buttocks) and responder rates of 80% for foot and groin, 75% for leg, and 70% for back. A substantial improvement in all PROs was observed at 12 months. The most commonly reported procedural or device complications were pain at the IPG pocket site, lead fracture, lead migration, and infection. Conclusions DRG stimulation is an effective and safe therapy for various etiologies of chronic pain.