gms | German Medical Science

66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Dorsal root ganglion stimulation for treatment of phantom limb pain

Meeting Abstract

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  • Gregor Bara - Klinik für Funktionelle Neurochirurgie und Stereotaxie, Universitätsklinikum Düsseldorf
  • Stefan Schu - Klinik für Funktionelle Neurochirurgie und Stereotaxie, Universitätsklinikum Düsseldorf
  • Jaroslaw Maciaczyk - Klinik für Funktionelle Neurochirurgie und Stereotaxie, Universitätsklinikum Düsseldorf
  • Jan Vesper - Klinik für Funktionelle Neurochirurgie und Stereotaxie, Universitätsklinikum Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP 109

doi: 10.3205/15dgnc507, urn:nbn:de:0183-15dgnc5072

Published: June 2, 2015

© 2015 Bara et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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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.