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Case Reports
. 2024 Feb 2;3(1):100389.
doi: 10.1016/j.inpm.2024.100389. eCollection 2024 Mar.

Dorsal root ganglion stimulation provides significant functional improvement from acute debilitating Crohn's disease: A novel use

Harman Chopra  1 , Melissa Jackels  1 , Michael Suarez  2 , Peter D Vu  3 , Mustafa Broachwala  1 , Tariq AlFarra  4 , Eellan Sivanesan  1
Affiliations
Case Reports

Dorsal root ganglion stimulation provides significant functional improvement from acute debilitating Crohn's disease: A novel use

Harman Chopra et al. Interv Pain Med. .

Abstract

Crohn's disease is a chronic inflammatory bowel condition causing symptoms, notably pain, due to ongoing intestinal inflammation or complications like abscesses, strictures, and fistulas, which are common in IBD patients. Abdominal pain affects up to 60 % of IBD patients, irrespective of disease severity, prompting medical attention. Various medications like NSAIDs, antidepressants, antispasmodics, anticonvulsants, and opioids are used to manage pain, but they have limited effectiveness and potential side effects, even during remission. In this case, a 20-year-old Caucasian female college student [height 5'4″, weight 120lbs (54.4 kg)] with juvenile idiopathic arthritis and Crohn's disease experienced severe daily abdominal pain, negatively impacting her life. Despite a multimodal regimen, including gabapentin, nortriptyline, duloxetine, and acetaminophen, her pain persisted, significantly affecting her appetite, sleep, mood, activity level, and overall quality of life (QOL). To address this, dorsal root ganglion (DRG) stimulation was considered. The patient aimed for a 20 % pain reduction and improved QOL. Trial leads were placed along the T10 and T12 DRG, resulting in a 25 % pain reduction (8-6 out of 10) and substantial QOL improvement. She could eat, sleep without interruptions, walk longer distances, and be more active. The T12 lead was more effective than the T10, targeting upper abdomen stimulation. The patient and her mother were highly satisfied and opted for permanent implantation for the T11 and T12 DRG. While DRG stimulation was approved in 2016 for chronic pain, to our knowledge, this is the first reported case of its use in a patient with debilitating Crohn's disease.

Keywords: Acute pain crisis; Crohns; DRG; IBD; IBD flare; Neuromodulation; Neuropathic pain.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Pain distribution described by patient on initial encounter.
Fig. 2
Fig. 2
T10/T12 DRG trial lead placement.
Fig. 3
Fig. 3
Lead placement at T11/T12 DRG for permanent implant.
See this image and copyright information in PMC

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