Dorsal Root Ganglion Stimulation
New and emerging neurostimulation devices are becoming a preferred non-opioid alternative for treating chronic pain. Spinal cord stimulation (SMS) is one of these options, however for some patients, it isn’t sufficiently effective for complex regional pain syndrome in the lower extremities – areas such as the hand, chest, abdomen, foot, knee or groin. Since early 2016, the FDA has approved an additional alternative – dorsal root ganglion (DRG) stimulation.
The concept behind dorsal root ganglion (DRG) stimulation is nearly identical to traditional spinal cord stimulation (SMS). With both options, a small device, similar to a pacemaker, is implanted in the body and pain signals are masked before the reach the brain. However, there is a key difference. With spinal cord stimulation, leads are placed in the general region of the spinal cord, while dorsal root ganglion therapy targets posterior nerve roots in a way that permits focused therapy to specific defined areas of the body.
Before a dorsal root ganglion stimulator is permanently implanted, a trial stimulation is always performed. If the trial does not live up to expectations, the trial wires can be removed in a simple office procedure with almost no discomfort and without damaging the spinal cord and nerves.
St. Jude Medical™ Axium™ Neurostimulator
Treatment in Depth
These “pacemakers for pain” interrupt the pain signals’ pathways to the brain by delivering low-intensity electrical pulses that trigger selective nerve fibers on the dorsal root ganglion, a cluster of neurons in the posterior root of spinal nerves. DRG stimulation offers a highly-directed stimulation field, which can limit stimulation to a specific pain area.
Because the layer between the lead wires and the dorsal root ganglion cells is so narrow, dorsal root ganglion (DRG) stimulation uses only about 10 percent of the energy required for traditional spinal cord stimulation (SMS). That, in turn, leads to longer-lasting batteries. In addition, the pattern of stimulation for DRG is constant, where that pattern of SMS stimulation can vary according to body position – as a result, DRG pain relief is much more consistent by comparison.
Manufacturers and Dorsal Root Ganglion Stimulator Options
St. Jude Medical’s Axium™ Neurostimulator System is approved by the FDA to treat patients with neuropathic chronic intractable pain associated with complex regional pain syndrome of the lower limbs.
Each dorsal root ganglion stimulation pulse generator features programmable settings. These settings can be adjusted to help you receive the best therapy possible. Your doctor will customize your system so that your pulse generator operates optimally for your individual situation.
Trial Period and Implant Procedure
If the trial procedure is successful, a dorsal root ganglion stimulator about the size of a small pocket watch is implanted under the skin in a minimally invasive outpatient procedure. The neurostimulator delivers controlled electrical pulses through leads to the dorsal root ganglion to block pain signals from reaching the brain. Your physician will adjust the stimulation settings to optimize the therapy and pain control for you.