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

Authors

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

Keywords:

Dorsal root ganglion stimulation, efficacy, neuromodulation, safety, spinal cord stimulation

Abstract

Objective: Dorsal root ganglion stimulation (DRGS) received its first regulatory approval (CE marking in Europe) in late 2011, andso its use is now almost six years old. Several thousand patients have already been treated, and a landmark trial in lower limbcomplex regional pain syndrome (CRPS) and causalgia has recently been published.
Methods: In this review we have summarized the literature to date on the use of DRGS in the treatment of neuropathic pain.
Results: The results so far are encouraging, with reports of successful use in treating a wide range of indications including postsurgical pain, CRPS, and phantom pain. Treatment of failed back surgery syndrome (FBSS) appears less successful. The therapy is still young, and long term results are not yet available. There is now good randomized clinical trial (RCT) evidence that DRGS provides superior pain relief to spinal cord stimulation for CRPS and causalgia of the lower limb, and produces stimulation that is more posturally stable, with more precise paraesthesia coverage. However evidence of this quality for other indications and pain locations is lacking.
Conclusion: There is now Class A RCT evidence that DRGS provides superior pain relief to SCS for CRPS and causalgia of the lowerlimb. In the coming years we hope that randomized controlled trials will be performed on an indication-by-indication basis, which, together with the publication of longer term follow-up data, will provide a more complete understanding of the role of DRGS inthe treatment of neuropathic pain syndromes.

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