gms | German Medical Science

Objective: 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 difficult-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.

Method: Three patients with phantom limb pain presented in our clinic. Patient 1 had presented 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 a 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 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.

Conclusions: 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.