A Systematic Literature Review of Dorsal Root Ganglion Neurostimulation for the Treatment of Pain

Timothy R Deer; Corey W Hunter; Pankaj Mehta; Dawood Sayed; Jay S Grider; Tim J Lamer; Jason E Pope; Steven Falowski; David A Provenzano; Michael F Esposito; Konstantin V Slavin; Ganesan Baranidharan; Marc Russo; Navdeep S Jassal; Alon Y Mogilner; Leo Kapural; Paul Verrills; Kasra Amirdelfan; W Porter McRoberts; Michael E Harned; Kenneth B Chapman; Liong Liem; Jonathan D Carlson; Ajax Yang; Rohit Aiyer; Ajay Antony; Michael A Fishman; Adnan A Al-Kaisy; Nick Christelis; Robert M Levy; Nagy Mekhail

doi:10.1093/pm/pnaa005

A Systematic Literature Review of Dorsal Root Ganglion Neurostimulation for the Treatment of Pain

Pain Med. 2020 Aug 1;21(8):1581-1589. doi: 10.1093/pm/pnaa005.

Authors

Timothy R Deer¹, Corey W Hunter², Pankaj Mehta³, Dawood Sayed⁴, Jay S Grider⁵, Tim J Lamer⁶, Jason E Pope⁷, Steven Falowski⁸, David A Provenzano⁹, Michael F Esposito¹⁰, Konstantin V Slavin¹¹, Ganesan Baranidharan¹², Marc Russo¹³, Navdeep S Jassal¹⁴, Alon Y Mogilner¹⁵, Leo Kapural¹⁶, Paul Verrills¹⁷, Kasra Amirdelfan¹⁸, W Porter McRoberts¹⁹, Michael E Harned²⁰, Kenneth B Chapman²¹, Liong Liem²², Jonathan D Carlson²³, Ajax Yang²⁴, Rohit Aiyer²⁵, Ajay Antony²⁶, Michael A Fishman²⁷, Adnan A Al-Kaisy²⁸, Nick Christelis²⁹, Robert M Levy³⁰, Nagy Mekhail³¹

Affiliations

¹ Spine and Nerve Center of the Virginias, Charleston, West Virginia.
² Ainsworth Institute of Pain Management, New York, New York.
³ Pain Specialists of America, Austin, Texas.
⁴ University of Kansas Medical Center, Kansas City, Kansas.
⁵ UK HealthCare Pain Services, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, Kentucky.
⁶ Division of Pain Medicine, Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota.
⁷ Evolve Restorative Center, Santa Rosa, California.
⁸ Department of Neurosurgery, Neurosurgical Associates of Lancaster, Lancaster, Pennsylvania.
⁹ Pain Diagnostics and Interventional Care, Sewickley, Pennsylvania.
¹⁰ Florida Pain Institute, Melbourne, Florida.
¹¹ Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
¹² Leeds Teaching Hospital, NHS Trust, Leeds, UK.
¹³ Hunter Pain Specialists, Broadmeadow, NSW, Australia.
¹⁴ Department of Neurology/Pain, University of South Florida, Spine & Pain Institute of Florida, Lakeland, Florida.
¹⁵ Department of Neurosurgery, NYU Langone Medical Center, New York, New York.
¹⁶ Carolina Pain Institute at Brookstown, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA.
¹⁷ Metro Spinal Clinic, Melbourne, Victoria, Australia.
¹⁸ IPM Medical Group, Walnut Creek, California.
¹⁹ Anodyne Research, Pennsylvania.
²⁰ Department of Anesthesiology, University of Kentucky, Lexington, Kentucky.
²¹ The Spine Institute of New York, New York, New York, USA.
²² St. Antonius Hospital, Nieuwegein, the Netherlands.
²³ Arizona Pain/Pain Doctor, Midwestern Medical School, Glendale, Arizona.
²⁴ Mt. Sinai Hospital, New York, New York.
²⁵ Interventional Pain Management and Pain Psychiatry Faculty, Henry Ford Health System Detroit, Michigan.
²⁶ University of Florida College of Medicine, Jacksonville, Florida.
²⁷ Center for Interventional Pain and Spine, Bryn Mawr, Pennsylvania, USA.
²⁸ Pain Management and Neuromodulation Centre at Guy's and St. Thomas' NHS Trust, London, UK.
²⁹ Pain Specialists Australia, Monash University, Richmond, Victoria, Australia.
³⁰ Neurosurgical Services and of Clinical Research, Anesthesia Pain Care Consultants, Tamarac, Florida.
³¹ Evidence-Based Pain Management Research and Education, Cleveland Clinic, Cleveland, Ohio, USA.

PMID: 32803221
DOI: 10.1093/pm/pnaa005

Abstract

Objective: To conduct a systematic literature review of dorsal root ganglion (DRG) stimulation for pain.

Design: Grade the evidence for DRG stimulation.

Methods: An international, interdisciplinary work group conducted a literature search for DRG stimulation. Abstracts were reviewed to select studies for grading. General inclusion criteria were prospective trials (randomized controlled trials and observational studies) that were not part of a larger or previously reported group. Excluded studies were retrospective, too small, or existed only as abstracts. Studies were graded using the modified Interventional Pain Management Techniques-Quality Appraisal of Reliability and Risk of Bias Assessment, the Cochrane Collaborations Risk of Bias assessment, and the US Preventative Services Task Force level-of-evidence criteria.

Results: DRG stimulation has Level II evidence (moderate) based upon one high-quality pivotal randomized controlled trial and two lower-quality studies.

Conclusions: Moderate-level evidence supports DRG stimulation for treating chronic focal neuropathic pain and complex regional pain syndrome.

Keywords: Chronic Pain; Dorsal Root Ganglion Stimulation; Pain Management; Systematic Review.

Publication types

Systematic Review

MeSH terms

Ganglia, Spinal*
Humans
Neuralgia* / therapy
Prospective Studies
Reproducibility of Results
Retrospective Studies