Abstract
Introduction: Recently, we have explored the feasibility of percutaneous transforaminal lead placement through a lateral endoscopic technique for burst-mode dorsal root ganglion (DRG) stimulation. This innovative approach aims to address the challenges DRG lead placement in patients who previous underwent prior spinal surgery with epidural scar formation and to improve the outcomes of DRG stimulation. Here we present the results of a prospective single-center cohort study examining BurstDR DRG stimulation via endoscopic transforaminal lead placement. Further we elaborate on the technique of programming.
Materials / Methods: 15 patients suffering from persistent spinal pain syndrome with predominant radicular pain who previously underwent a trial for spinal cord stimulation without significant pain reduction were enrolled. Leads were placed transforaminally via a lateral endoscopic technique and burst-mode dorsal root ganglion (DRG) stimulation was applied. Data collection included pain intensity measured in cm on VAS, Oswestry disability index (ODI), and health related quality of life (EQ5D). Data was collected prior to surgery, 2 days after surgery, 6 weeks after surgery and 12 weeks after surgery.
Results: This study showes the feasibility of endoscopic DRG lead placement and BurstDR stimulation. Significant improvements regarding pain intensity during rest and motion, disability as well as health related quality of life could be observed. The effects improved further during the postoperative course.
Discussion: This single center, prospectove cohort study shows that burst stimulation on the dorsal root ganglion is feasable and can produce sufficient pain reduction, improvement of mobility and quality of life in cases of persistent spinal pain syndrome type 2. In particular, DRG burst stimulation showed to be more potent in a subset of patients who failed prior spinal cord stimulation.
Conclusions: BurstDR DRG stimulation applied via percutaneous lateral endoscopic transforaminal lead placement is feasible in a wider patient cohort and significantly eases disease burden in a subset of patients who previously failed spinal cord stimulation and underwent prior spine surgery making conventional DRG lead placement impossible due to epidural scar formation.
Oral presentation.