La eficacia y seguridad de la estimulación del ganglio de la raíz dorsal como tratamiento para el dolor neuropático: una revisión de la literatura.: Trabajo publicado en Neuromodulation 2018; 21: 225–233 Traducción Dr. Pablo Pino Lozano

Conrad Harrison; Sarah Epton; Stana  Bojanic; Alexander L. Green; James J. FitzGerald

doi:10.47924/neurotarget201941

Autores/as

Conrad Harrison Vascular Research Department, St George’s Hospital, London, UK
Sarah Epton John Radcliffe Hospital, University of Oxford Medical Sciences Office, Oxford, UK
Stana Bojanic John Radcliffe Hospital, University of Oxford Medical Sciences Office, Oxford, UK
Alexander L. Green Vascular Research Department, St George’s Hospital, London, UK
James J. FitzGerald Vascular Research Department, St George’s Hospital, London, UK

DOI:

https://doi.org/10.47924/neurotarget201941

Palabras clave:

estimulación del ganglio de la raíz dorsal, eficacia, neuromodulación, seguridad, estimulación de la médula espinal

Resumen

Objetivo: La estimulación del ganglio de la raíz dorsal (EGRD) recibió su primera aprobación reglamentaria (marcado CE en Europa) a finales de 2011, por lo que su uso tiene ahora casi ocho años. Varios miles de pacientes ya han sido tratados, y recientemente se ha publicado un trascendental ensayo sobre el síndrome de dolor regional complejo (SDRC) y la causalgia en las extremidades inferiores.
Métodos: En esta revisión hemos resumido la literatura disponible a la fecha sobre el uso de la EGRD en el tratamiento del dolor neuropático. Resultados: Los resultados hasta ahora son alentadores, con informes de uso exitoso en el tratamiento de una amplia gama de indicaciones que incluyen dolor posquirúrgico, SDRC y dolor fantasma. El tratamiento del síndrome de cirugía fallida de columna parece ser menos exitoso. La terapia aún es joven, y los resultados a largo plazo aún no están disponibles. Ahora existe una buena evidencia de ensayos clínicos aleatorizados (ECA) de que la EGRD proporciona un alivio superior del dolor al obtenido con la estimulación de la médula espinal para el SDRC y la causalgia en las extremidades inferiores, y produce una estimulación más estable posturalmente, con una cobertura más precisa de las parestesias. Sin embargo, falta evidencia de esta calidad para otras indicaciones y localizaciones del dolor. Conclusión: Ahora hay pruebas de ECA de clase A de que la EGRD proporciona un alivio superior del dolor a la estimulación de la médula espinal para el SDRC y la causalgia en las extremidades inferiores. Esperamos que en los próximos años los ensayos controlados aleatorizados se realicen indicación por indicación, lo que, junto con la publicación de datos de seguimiento a más largo plazo, proporcionarán una comprensión más completa del papel de la EGRD en el tratamiento de los síndromes de dolor neuropático.

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