Combined Wireless Spinal Cord Stimulation, Dorsal Root Ganglion Stimulation, and Peripheral Nerve Stimulation for Treating Low Back Pain

Abstract

Background: Neuromodulation has undergone significant advances over the past decade, particularly when the DRG and PNS modalities evolved to target conditions that are hard to cover by conventional SCS. The availability of a variety of stimulation modalities allows for a customized approach. Case Presentation: A 49-year-old man presented with low back and buttock pain. The patient had a history of chronic lower back pain, L4/L5 and L5/S1 facet hypertrophy, a 3-mm left paracentral and foraminal disc protrusion minimally involving the left S1 nerve root, and right low back/buttock/hip pain after previous surgical removal of an episacroiliac lipoma on the right sacroiliac joint. Despite multiple therapies such as oral opioids, anticonvulsants, and physical therapy, the patient continued to experience right lower back and buttock pain. Conclusion: The patient’s pain scores decreased from a baseline score of 8 out of 10 without medication to a 1 out of 10 without medication. The wireless SCS and PNS significantly reduced pain scores for this patient suffering from lower back, buttock, and hip pain. Key words: Dorsal root ganglion, low back pain, peripheral nerve stimulation, spinal cord stimulation