Morgalla Matthias Hubert, Bolat Anil, Fortunato Marcos, Lepski Guilherme, Chander Bankim Subhash
Department of Neurosurgery, University of Tuebingen, Tuebingen, Germany.
Neuromodulation. 2017 Dec;20(8):753-760. doi: 10.1111/ner.12713. Epub 2017 Nov 13.
Chronic neuropathic pain in the groin is a severe condition and difficult to treat. Dorsal root ganglion stimulation (DRGS) covers discrete painful areas precisely with its stimulation power in comparison to spinal cord stimulation (SCS). It was our hypothesis that DRGS provides a long-term relief of chronic groin pain over a period of more than three years.
Patients (age >18 years) with chronic neuropathic groin pain were prospectively examined. After a successful test-trial (duration of 3-10 days, pain decrease >50%) a permanent generator was implanted. The patients were re-examined after three months, then after one year, two, and three years. We used the Visual Analogue Scale (VAS), the Pain Disability Index (PDI), the Pain Catastrophizing Scale (PCS), the Brief Pain Inventory (BPI), and the Beck Depression Inventory (BDI) for the assessment.
We included 34 consecutive patients (13 female, 21 male, mean age 50.4 years, range of age 24-84 years, 30/34 trial to permanent conversion) during the time period from 2012 until 2016. Thirty patients had a successful test-trial and a generator was subsequently implanted. Results after three years: the preoperative VAS dropped from Mdn = 8 to Mdn = 4.5 (p = 0.001). The PDI decreased from Mdn = 48 to Mdn = 23 (p = 0.004). The PCS changed from Mdn = 31 to Mdn = 16 (p = 0.006). The BPI dropped from Mdn = 76 to Mdn = 30 (p = 0.003). The BDI decreased from Mdn = 17 to Mdn = 7 (p = 0.010). Five patients showed complications (16.7%).
In this study, DRGS proved an efficient long-term method for the treatment of chronic neuropathic groin pain and we strongly recommend its use.
腹股沟区慢性神经性疼痛是一种严重且难以治疗的病症。与脊髓刺激（SCS）相比，背根神经节刺激（DRGS）能凭借其刺激能量精确覆盖离散的疼痛区域。我们的假设是，DRGS能在三年多的时间里为慢性腹股沟疼痛提供长期缓解。
对患有慢性神经性腹股沟疼痛的患者（年龄>18岁）进行前瞻性检查。在成功进行试验性治疗（持续3 - 10天，疼痛减轻>50%）后植入永久性发生器。患者在三个月后、一年后、两年后和三年后接受复查。我们使用视觉模拟量表（VAS）、疼痛残疾指数（PDI）、疼痛灾难化量表（PCS）、简明疼痛问卷（BPI）和贝克抑郁量表（BDI）进行评估。
在2012年至2016年期间，我们纳入了34例连续患者（13例女性，21例男性，平均年龄50.4岁，年龄范围24 - 84岁，30/34例试验性治疗后转为永久性植入）。30例患者试验性治疗成功，随后植入了发生器。三年后的结果：术前VAS从中位数=8降至中位数=4.5（p = 0.001）。PDI从中位数=48降至中位数=23（p = 0.004）。PCS从中位数=31变为中位数=16（p = 0.006）。BPI从中位数=76降至中位数=30（p = 0.003）。BDI从中位数=17降至中位数=7（p = 0.010）。5例患者出现并发症（16.7%）。
在本研究中，DRGS被证明是治疗慢性神经性腹股沟疼痛的一种有效的长期方法，我们强烈推荐使用。
