Dorsal Root Ganglion Stimulation for Treatment of Chronic Upper Abdominal Pain: A Case Report

Abstract

BACKGROUND: The use of dorsal root ganglion stimulation (DRGS) has been widely reported in the treatment of inguinal and groin pain, post-herniorrhaphy pain. The use of the DRGS has more recently been proposed for upper abdominal symptoms. In this case report, we detail the potential use of dorsal root ganglion stimulation for the treatment of postoperative right upper quadrant abdominal pain. CASE REPORT: A 55 year-old female with history of pancreatic cancer with multiple abdominal surgeries including Whipple procedure. The patient presented to an outpatient interventional pain clinic with chronic upper abdominal pain symptoms. Recent gastrointestinal and spinal work-up was unremarkable. Having exhausted all conservative measures the patient was offered DRGS trial. The trial leads were placed at the right T7 and T8 dorsal root ganglion. The procedure was performed with conscious sedation and was well-tolerated. CONCLUSIONS: Dorsal root ganglion stimulation (DRGS) presents a unique method of capturing upper abdominal visceral pain symptoms. The efficacy of DRGS offers another option in addition to conventional treatment, as well as dorsal column spinal cord stimulation (DC-SCS). Due in part to its use of selective dermatomal distribution of sensory perception one can reliably target a specific region of the abdomen where DC-SCS may not. KEY WORDS: Dorsal root ganglion stimulation, neuromodulation, abdominal pain, chronic pain