title: Spinal cord stimulation of the dorsal root ganglion for groin pain-a retrospective review.
abstract: BACKGROUND
  Spinal cord stimulation (SCS) is a standard treatment option for chronic neuropathic pain. However, some anatomical pain distributions are known to be difficult to cover with traditional SCS-induced paresthesias and/or may also induce additional, unwanted stimulation. We present the results from a retrospective review of data from patients with groin pain of various etiologies treated using neuromodulation of the dorsal root ganglion (DRG).
  
  
  METHODS
  Data from 29 patients with neuropathic groin pain were reviewed. Patients underwent trial therapy where specifically designed leads were implanted at the target DRGs between T12 and L4. Patients who had a successful trial (> 50% improvement) received the fully implantable neuromodulation system. Pain scores were captured on a visual analog scale (VAS) at baseline and at regular follow-up visits.
  
  
  RESULTS
  Twenty-five patients (86.2%) received fully implantable neurostimulators, and the average follow-up period was 27.8 ± 4.3 (standard error of the mean, SEM) weeks. The average pain reduction was 71.4 ± 5.6%, and 82.6% (19/23) of patients experienced a > 50% reduction in their pain at the latest follow-up. Individual cases showed improvement with a variety of etiologies and pain distributions; a subanalysis of postherniorrhaphy cohort also showed significant improvement.
  
  
  CONCLUSIONS
  Early findings suggest that neuromodulation of the DRG may be an effective treatment for chronic neuropathic pain conditions in the groin region. This technique offers a useful alternative for pain conditions that do not always respond optimally to traditional SCS therapy. Neuromodulation of the DRG provided excellent cross-dermatomal paresthesia coverage, even in cases with patients with discrete pain areas. The therapy can be specific, sustained, and independent of body position.
authors.affiliation: Department of Functional Neurosurgery, University Hospital of Düsseldorf, Düsseldorf, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schu
authors.forename: Ashish
authors.initials: A
authors.lastname: Gulve
authors.forename: Sam
authors.initials: S
authors.lastname: ElDabe
authors.forename: Ganesan
authors.initials: G
authors.lastname: Baranidharan
authors.forename: Katharina
authors.initials: K
authors.lastname: Wolf
authors.forename: Walter
authors.initials: W
authors.lastname: Demmel
authors.forename: Dirk
authors.initials: D
authors.lastname: Rasche
authors.forename: Manohar
authors.initials: M
authors.lastname: Sharma
authors.forename: Daniel
authors.initials: D
authors.lastname: Klase
authors.forename: Gunnar
authors.initials: G
authors.lastname: Jahnichen
authors.forename: Anders
authors.initials: A
authors.lastname: Wahlstedt
authors.forename: Harold
authors.initials: H
authors.lastname: Nijhuis
authors.forename: Liong
authors.initials: L
authors.lastname: Liem
mesh_terms: D015331:Cohort Studies; D005260:Female; D005727:Ganglia, Spinal / Q000502:physiology; D006119:Groin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis / Q000628:therapy; D010147:Pain Measurement / Q000379:methods; D017699:Pelvic Pain / Q000175:diagnosis* / Q000628:therapy*; D012189:Retrospective Studies; D062187:Spinal Cord Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: dorsal root ganglion; dorsal root ganglion stimulation; groin pain; neuropathic pain; spinal cord stimulation