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dc.contributor.authorVan Buyten JPen_US
dc.contributor.authorSmet Ien_US
dc.contributor.authorLiem Len_US
dc.contributor.authorRusso Men_US
dc.contributor.authorHuygen Fen_US
dc.description.abstractBACKGROUND: Complex regional pain syndrome (CRPS) is a chronic and progressive pain condition usually involving the extremities and characterized by sensorimotor, vascular, and trophic changes. Spinal cord stimulation (SCS) is an effective intervention for this condition, but is hampered by the technical challenges associated with precisely directing stimulation to distal extremities. Dorsal root ganglia (DRG) may be more effective as a physiological target for electrical modulation due to recruitment of the primary sensory neurons that innervate the painful distal anatomical regions. METHODS: Eleven subjects diagnosed with uni- or bilateral lower-extremity CRPS were recruited as part of a larger study involving chronic pain of heterogeneous etiologies. Quadripolar epidural leads of a newly developed neurostimulation system were placed near lumbar DRGs using conventional percutaneous techniques. The neurostimulators were trialed; 8 were successful and permanently implanted and programed to achieve optimal pain-paresthesia overlap. RESULTS: All 8 subjects experienced some degree of pain relief and subjective improvement in function, as measured by multiple metrics. One month after implantation of the neurostimulator, there was significant reduction in average self-reported pain to 62% relative to baseline values. Pain relief persisted through 12 months in most subjects. In some subjects, edema and trophic skin changes associated with CRPS were also mitigated and function improved. Neuromodulation of the DRG was able to provide excellent pain-paresthesia concordance in locations that are typically hard to target with traditional SCS, and the stimulation reduced the area of pain distributions. CONCLUSIONS: Neuromodulation of the DRG appears to be a promising option for relieving chronic pain and other symptoms associated with CRPS. The capture of discrete painful areas such as the feet, combined with stable paresthesia intensities independent of body position, suggests this stimulation modality may allow more selective and consistent targeting of painful areas than traditional SCS.en_US
dc.subjectcomplex regional pain syndromeen_US
dc.subjectdorsal root ganglionen_US
dc.subjectSpinal Cord Stimulationen_US
dc.titleStimulation of Dorsal Root Ganglia for the Management of Complex Regional Pain Syndrome: A Prospective Case Seriesen_US
dc.typeJournal Articleen_US
dc.identifier.journaltitlePain Practiceen_US
dc.description.affiliatesMultidisciplinary Pain Center, Algemeen Ziekenhuis Nikolaasen_US
dc.description.affiliatesSint Antonius Hospital, Nieuwegeinen_US
dc.description.affiliatesHunter Pain Clinicen_US
dc.description.affiliatesErasmus University, Rotterdamen_US
dc.type.studyortrialCase Series and Case Reportsen_US
item.openairetypeJournal Article-
item.fulltextWith Fulltext-
Appears in Collections:Scholarly and Clinical
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