Artikel
Dorsal root ganglion stimulation under real life conditions – a single-centre case series of 115 patients
Spinalganglion-Stimulation im klinischen Alltag – eine konsekutive Fallserie von 115 Fällen
Suche in Medline nach
Autoren
-
Philipp J. Slotty
- Heinrich-Heine-Universität, Universitätsklinikum, Abteilung für Stereotaxie und Funktionelle Neurochirurgie, Düsseldorf, Deutschland
-
Stefan Schu
- Sana Kliniken Wedau, Duisburg, Deutschland
-
Apostolos Chatzikalfas
- Heinrich-Heine-Universität, Universitätsklinikum, Abteilung für Stereotaxie und Funktionelle Neurochirurgie, Düsseldorf, Deutschland
-
Jan Vesper
- Heinrich-Heine-Universität, Universitätsklinikum, Abteilung für Stereotaxie und Funktionelle Neurochirurgie, Düsseldorf, Deutschland
| Veröffentlicht: | 8. Mai 2019 |
|---|
Gliederung
Text
Objective: Dorsal root ganglion stimulation has established its role in chronic pain states of different origin. The bulk of data on DRG stimulation originates from small case series and clinical trials. We report a consecutive series of 115 patients treated in the clinical routine to provide unfiltered data of DRG stimulation results.
Methods: Between January 2014 and February 2018 115 patients were implanted with DRG electrode in a single neuromodulation unit. In most patients, trialing was performed and considered successful if an at least 50% pain reduction could be achieved. Data on these patients was prospectively collected during in- and out-patient follow-ups. Beside response to stimulation measured by pain reduction, trial-to-implant ratio and explantation rates were recorded.
Results: Of 115 patients implanted with leads, 104 were implanted with a permanent system resulting in a trail-to-implant percentage of 90.4 percent. The mean pain levels at baseline were 8.6 cm VAS (range 6.0–10.0). Stimulation with the permanent system resulted in a decrease in pain levels to a mean of 4.1 (range 0–10), mean time to first follow-up was 1.9 month (2nd f/u @ 9.5 month VAS 5.1, 3rd f/u @ 18.9 month VAS 4.2, 4th f/u 23.6 month VAS 5.3). 23 patients had their devices removed due to inefficacy (19.8%). Parametric testing for statistical differences resulted in highly significant reduction of pain levels between baseline VAS and all consecutive follow-ups.
Conclusion: This data provides an overview of DRG stimulation results from a mixture of indications and includes patients from the introduction of this therapy in the market, this might influence observed outcomes negatively. Additionally, only patients with insufficient or mediocre stimulations efficacy might have shown up for out-patient follow-up as patients were not actively followed. This might additionally negatively influence follow-up data and has to be kept in mind when interpreting the results. Despite these considerations, DRG stimulation resulted in a statistically significant and stable treatment response. Explantation numbers are higher than anticipated.
