Acevedo-Gonzalez Juan Carlos, Ariza-Piñeros Carlos Felipe, Vega-Corredor José Manuel
Facultad de Medicina, Departamento de Neurociencias, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia.
Pain Pract. 2025 Feb;25(2):e70008. doi: 10.1111/papr.70008.
In the last 20 years, we have seen the flourishing of multiple treatments targeting the dorsal root ganglion (DRG) for pain. However, there is concern regarding the variation in the location of the DRG, which could influence the long-term clinical outcomes. The aim of this work was to determine the exact position of the DRG in the spine and propose a pre-surgical planning.
A systematic search was conducted following the principles recommended by PRISMA. Search terms "ganglia," "DRG," "dorsal root ganglia, anatomy," "radiological," "neuromodulation," "dorsal root ganglion stimulation" (PubMed, Scopus, Medline, Web of Science, and Embase) were identified 177 articles and subjected to the selection criteria (inclusion/exclusion) based on the independent review of the abstracts.
Eighteen articles were selected (seven anatomical dissections on cadavers, five radiological studies, and six narrative reviews).
Percutaneous procedure targeting the DRG for the treatment of chronic pain requires preoperative planning independent to the study of the etiology of pain. The DRG should be typified using magnetic resonance imaging. We propose a preoperative evaluation scale based on four specific items: A-position in the vertebral canal, B-position of the DRG within the foramen, C-number of ganglia in the root, and D-ratio (proportion) of foramen/DRG.
Percutaneous treatments for chronic pain directed at the DRG are effective. Clinical outcomes depend of good preoperative planning that allows for optimizing its effects. We propose a DRG morphology evaluation scale useful for the planning process prior to any treatment directed at the ganglion.
在过去20年里，我们见证了多种针对背根神经节（DRG）治疗疼痛的方法蓬勃发展。然而，人们担心DRG位置的变化可能会影响长期临床疗效。这项工作的目的是确定DRG在脊柱中的精确位置，并提出术前规划。
按照PRISMA推荐的原则进行系统检索。检索词“神经节”“DRG”“背根神经节，解剖学”“放射学”“神经调节”“背根神经节刺激”（PubMed、Scopus、Medline、Web of Science和Embase），共识别出177篇文章，并根据对摘要的独立评审进行纳入/排除标准筛选。
筛选出18篇文章（7篇尸体解剖研究、5篇放射学研究和6篇叙述性综述）。
针对DRG的经皮治疗慢性疼痛需要独立于疼痛病因研究的术前规划。应使用磁共振成像对DRG进行分型。我们基于四个具体项目提出了一个术前评估量表：A-在椎管内的位置、B-DRG在椎间孔内的位置、C-神经根中神经节的数量以及D-椎间孔/DRG的比例。
针对DRG的慢性疼痛经皮治疗是有效的。临床疗效取决于良好的术前规划，这有助于优化其效果。我们提出了一个DRG形态评估量表，对针对神经节的任何治疗之前的规划过程都很有用。
