Liem Liong, Russo Marc, Huygen Frank J P M, Van Buyten Jean-Pierre, Smet Iris, Verrills Paul, Cousins Michael, Brooker Charles, Levy Robert, Deer Timothy, Kramer Jeffrey
Sint Antonius Hospital, Nieuwegein, The Netherlands.
Neuromodulation. 2015 Jan;18(1):41-8; discussion 48-9. doi: 10.1111/ner.12228. Epub 2014 Aug 21.
Spinal cord stimulation of the dorsal root ganglion (DRG-SCS) is a new therapy for treating chronic neuropathic pain. Previous work has demonstrated the effectiveness of DRG-SCS for pain associated with failed back surgery syndrome, complex regional pain syndrome, chronic postsurgical pain, and other etiologies through 6 months of treatment; this report describes the maintenance of pain relief, improvement in mood, and quality of life through 12 months.
Subjects with intractable pain in the back and/or lower limbs were implanted with an active neurostimulator device. Up to four percutaneous leads were placed epidurally near DRGs. Subjects were tracked prospectively for 12 months.
Overall, pain was reduced by 56% at 12 months post-implantation, and 60% of subjects reported greater than 50% improvement in their pain. Pain localized to the back, legs, and feet was reduced by 42%, 62%, and 80%, respectively. Measures of quality of life and mood were also improved over the course of the study, and subjects reported high levels of satisfaction. Importantly, excellent pain-paresthesia overlap was reported, remaining stable through 12 months.
Despite methodological differences in the literature, DRG-SCS appears to be comparable to traditional SCS in terms of pain relief and associated benefits in mood and quality of life. Its benefits may include the ability to achieve precise pain-paresthesia concordance, including in regions that are typically difficult to target with SCS, and to consistently maintain that coverage over time.
脊髓背根神经节刺激术(DRG-SCS)是一种治疗慢性神经性疼痛的新疗法。先前的研究已证明,通过6个月的治疗,DRG-SCS对与腰椎手术失败综合征、复杂性区域疼痛综合征、慢性术后疼痛及其他病因相关的疼痛有效;本报告描述了其在12个月内对疼痛缓解的维持情况、情绪改善情况及生活质量。
对背部和/或下肢顽固性疼痛的受试者植入有源神经刺激器装置。在背根神经节附近硬膜外最多放置4根经皮导线。对受试者进行前瞻性追踪12个月。
总体而言,植入后12个月时疼痛减轻了56%,60%的受试者报告疼痛改善超过50%。背部、腿部和足部的局部疼痛分别减轻了42%、62%和80%。在研究过程中,生活质量和情绪指标也得到了改善,受试者报告满意度较高。重要的是,报告显示疼痛与感觉异常重叠良好,在12个月内保持稳定。
尽管文献中的方法存在差异,但DRG-SCS在疼痛缓解以及对情绪和生活质量的相关益处方面似乎与传统脊髓刺激术相当。其益处可能包括能够实现精确的疼痛与感觉异常一致性,包括在传统脊髓刺激术通常难以靶向的区域,并能随着时间持续维持这种覆盖范围。