gms | German Medical Science

Introduction: Spinal Cord Stimulation has been widely used in the treatment of stump pain following limb amputation. Phantom limb pain, however, is thought to be a diffucult-to-treat chronic pain syndrome. Neither Spinal Cord Stimulation nor Motor Cortex Stimulation have proven their efficacy. Here we present a case series of three cases treated with dorsal root ganglion stimulation.

Material and methods: Three patients with phantom limb pain presented in our clinic. Patient 1 hadpresented with a L5 pain, Patient 2 with L4 pain, both due to leg amputation after an accident. Patient 3 presented with L5 phantom limb pain after amputation of the lower leg due to peripheral vascular disease. All Patients were implanted with a specially designed electrode to stimulate the dorsal root ganglion at the corresponding ganglion and connected to an fully implantable internal pulse generator. Lead placement and IG implantation was performed under general anesthesia. Data was collected prospectively. Pain scores were captured on a visual analog scale at baseline and regular follow ups.

Results: The median follow up was 6 months. Patients reported a pain reduction from from VAS 9.3 Patients 2 and 3 reported prompt pain reduction. Patient 1 however reported paresthesia coverage after 4 weeks and sufficient pain reduction after 6 weeks. Mean pain scores decreased from VAS 9.3 ± 0.3 to VAS 1.0 ± 0.57.

Conclusion: This case series of patients presenting with phantom limb pain shows Dorsal Root Ganglion Stimulation to be an effective treatment and a promising new target.