DRG neurons are involved in the transduction of pain to the central nervous system (CNS), serving as a filter for propagation of afferent signals to the dorsal horn. The dorsal root ganglion (DRG) contains a collection of cell bodies of primary sensory, pseudo-unipolar neurons in the lateral epidural space of the spinal foramen. There is very low-quality evidence demonstrating promising results for DRG-S in painful diabetic neuropathy, focal neuropathy, and polyneuropathy.Įfficacy of DRG-S for refractory postsurgical neuropathic pain of the groin (e.g., post-herniorrhaphy) or of the knee (e.g., post-total knee arthroplasty) has been demonstrated in small-scale observational studies. The highest level of evidence is demonstrated with DRG-S use for CRPS of the lower extremity, although the quality of evidence was downgraded to “low” because of risk of bias, imprecision, heterogeneity, and indirectness from included observational studies. Future powered randomized controlled trials with homogeneous participants are warranted.ĭorsal root ganglion stimulation (DRG-S) is a form of selective neuromodulation therapy that targets the dorsal root ganglion and offers analgesia in a variety of chronic pain conditions.ĭRG-S is currently approved by the US Food and Drug Administration for the treatment of neuropathic pain associated with complex regional pain syndrome (CRPS) and/or causalgia in the groin and lower extremity. We stratified presentation of results based of type of neuropathy (CRPS, painful diabetic neuropathy, mononeuropathy, polyneuropathy) as well as location of neuropathy (hip, knee, foot). The primary outcome was change in pain intensity after DRG-S compared to baseline. In this review, we appraised the current evidence for DRG-S in the treatment of lower extremity neuropathic pain using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria. There has been increasing utilization of DRG-S to treat various neuropathic pain syndromes of the lower extremity, although evidence remains limited to one randomized controlled trial and 39 observational studies. DRG-S offers analgesia in a variety of chronic pain conditions and is approved for treatment of complex regional pain syndrome (CRPS) by the US Food and Drug Administration (FDA). Dorsal root ganglion stimulation (DRG-S) is a form of selective neuromodulation therapy that targets the dorsal root ganglion.
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