Dorsal Root Ganglion Stimulation Therapy in Pediatric Patients: A Case Series

M. Graca, Bryce Austell, Amanda C Sremac, T. Lubenow
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Abstract

BACKGROUND: Dorsal root ganglion (DRG) stimulation therapy has been shown to provide effective relief in controlling chronic regional pain syndrome (CRPS)-related pain; however, there is little information on its efficacy and safety in pediatric patients. CASE REPORT: Following Institutional Review Board approval, a review of pediatric patients who underwent DRG therapy at a single university pain center was conducted. Five patients under 18 years old with CRPS or intercostal neuralgia who failed prior therapies received DRG stimulation therapy. Three of 5 patients (60%) reported 50% or more relief with DRG therapy. Secondary outcomes including resolution of allodynia, sudomotor and vasomotor dysfunction, and tropic changes as well as school/work attendance and reduced physical restrictions at the longest follow-up were improved in responders. CONCLUSION: In our limited series we found substantially improved analgesia, reduction in symptoms of CRPS, and improved functional outcomes in pediatric patients treated with DRG neuromodulation for unresponsive chronic pain. KEY WORDS: Chronic regional pain syndrome, intercostal neuralgia, neuromodulation, pediatric
儿童患者的背根神经节刺激疗法:一个病例系列
背景:刺激背根神经节(DRG)治疗已被证明可有效缓解慢性局部疼痛综合征(CRPS)相关疼痛;然而,关于其在儿科患者中的有效性和安全性的信息很少。病例报告:在机构审查委员会批准后,对在一所大学疼痛中心接受DRG治疗的儿科患者进行了审查。5例18岁以下CRPS或肋间神经痛患者既往治疗失败,接受DRG刺激治疗。5名患者中有3名(60%)报告DRG治疗缓解了50%或更多。次要结果包括异位性疼痛的缓解、压迫性和血管舒缩功能障碍、热带变化以及学校/工作出勤率和减少的身体限制在最长的随访中得到改善。结论:在我们有限的系列研究中,我们发现在接受DRG神经调节治疗无反应性慢性疼痛的儿科患者中,镇痛效果显著改善,CRPS症状减轻,功能预后改善。关键词:慢性局部疼痛综合征;肋间神经痛;神经调节
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