Dorsal Root Ganglion (DRG) Spinal Cord Stimulation
Devices to stimulate the dorsal root ganglion (DRG) became available in the mid-2010s for treating chronic pain, particularly in areas that were hard to treat with traditional spinal cord stimulation, such as the hand, chest, abdomen, foot, knee or groin.
The DRG is an easily accessible structure in the spine that plays a key role in the development and management of chronic neuropathic pain. It is a bundle of sensory nerve cell bodies within the epidural space. Each nerve root communicates to the dorsal root ganglion in a way that allows sensory messages from a defined area of the body. Therefore, applying stimulation to the DRG can permit focused therapy to a specific focal area.
DRG stimulation has been used successfully to treat neuropathic pain of the limbs, axial back, groin, chest wall, and phantom limb. The anatomy of the DRG allows for stimulation of the abnormal pain fibers more selectively than conventional spinal cord stimulation. This results in less energy requirement and, in many cases, pain relief at a sub-threshold level that is paraesthesia free. In addition to focusing on stimulation, DRG neuromodulation has a few other distinguishing aspects. At 12 months, patients who responded to the therapy were reported to have both less discomfort and also improved mood scores.