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. 2019 May 7;11(5):e4615.
doi: 10.7759/cureus.4615.

Dorsal Root Ganglion Stimulation for Thoracic Neuralgia: A Report of Six Cases

Casey L Anthony  1 , Muhibullah S Tora  1 , Jessica N Bentley  2 , Pavlos Texakalidis  3 , Nicholas M Boulis  1
Affiliations

Dorsal Root Ganglion Stimulation for Thoracic Neuralgia: A Report of Six Cases

Casey L Anthony et al. Cureus. .

Abstract

Objective: Thoracic neuralgia (TN) is a chronic pain syndrome that can be refractory to pharmacologic intervention and management by pain specialists. Dorsal root ganglion (DRG) stimulation has shown promise as a targeted and effective modality compared to traditional therapies for several indications but has not yet been applied in the thoracic region. This study aims to report the outcomes of off-label thoracic DRG stimulation in patients with refractory TN.

Methods: A retrospective chart review was performed at Emory University Hospital for patients who underwent thoracic DRG stimulation in a two-year period. Relevant outcomes for safety and efficacy were evaluated.

Results: Six patients were identified that underwent thoracic DRG stimulation for various etiologies of TN, including post-mastectomy, post-herpetic, and post-abdominoplasty neuralgia. All patients initially underwent trial DRG stimulation with a mean pre-operative visual analogue scale (VAS) (0-10) of 6.8 ± 1.6 (range: 4-8). Four of six patients (67%) were non-responders and did not pursue permanent implantation; two experienced pain with stimulation during the trial, and two patients experienced no significant benefit. In addition, all three patients with post-herpetic neuralgia did not respond to treatment. Two of six patients (33%) responded well to stimulation, elected to receive permanent leads, and reported significant pain relief with VAS scores of 0/10 and 1/10, and 100% reduction in morphine equivalent use. Complications included lead migration and need to reset stimulator programming.

Conclusions: DRG stimulation may be an effective therapy for patients experiencing chronic TN as a result of peripheral nerve injury; however, post-herpetic neuralgia may be unresponsive to this treatment. Future prospective studies are warranted to evaluate the feasibility of this procedure in patients with refractory TN.

Keywords: dorsal root ganglion; neuropathic pain; pain; stimulation; thoracic; thoracic neuralgia; thorax.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Pre- and Post-Operative Visual Analogue Pain Scores for All Patients
VAS – visual analogue scale, Pre-Op – pre-operative, Post-Op – post-operative.
See this image and copyright information in PMC

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