138 Open Dorsal Root Ganglion Lead Placement After Percutaneous Trialing: A Case Series

Abstract

INTRODUCTION: Dorsal root ganglion (DRG) stimulation is a newer mode of neurostimulation for neuropathic pain in which individual electrodes are placed over the dorsal root ganglion (DRG). Although designed for percutaneous placement, open placement of DRG has been described in small case series and case reports when percutaneous placement failed or was anatomically not considered feasible. This is the largest series of open DRG stimulator placement and the first performed after successful percutaneous trialing. METHODS: We present a case series of N = 6 patients who underwent successful DRG stimulator placement via open laminotomy/laminectomy technique after a successful percutaneous DRG stimulator trial performed by a pain management physician. RESULTS: At a median 7.3 months status post implant, all patients continue to report significant relief of pain with their stimulator. There were no serious adverse events. Mean fluoroscopy time/case was 49.7 seconds. Technical nuances of open DRG stimulator placement will be discussed. CONCLUSIONS: This is the largest series of open DRG stimulator placement that has been reported. We have observed good patient pain relief and no serious adverse events. Although more invasive, potential advantages of open DRG stimulator placement include direct anchoring technique and lower radiation exposure times for patients and staff. Open DRG stimulator technique via laminectomy/laminotomy may also improve adoption of DRG stimulation by spinal surgeons who are familiar with exposing the DRG with open technique.