Dorsal Root Ganglion Stimulation (DRG)
Dorsal Root Ganglion Stimulation (DRG) typically involves implanting an electronic device in the body to help relieve chronic back and leg pain. The device, called a "Dorsal Root Gangion stimulator" sends electrical impulses through wires/electrodes placed near the Dorsal Root Ganglion/Nerve root exiting the spinal cord; the impulses block pain signals from reaching the brain. DRG does not cure chronic pain but usually lessens it by 50-80 percent without parasthesia. Before implantation, a patient is asked to go through a trial period with an external device; this allows pain levels to be evaluated, and determine whether they decrease when the device is used. This device allows for more specific coverage of pain in a specfic area of the ie chronic post surgical foot pain.
Candidates for Dorsal Root Ganglion Stimulation.
Not everyone is a candidate for DRG. It is an option only for those who have tried, but been unsuccessful with, conservative treatments; will likely not be helped by surgery; are not addicted to drugs; have been psychologically evaluated; do not have pacemakers; and have undergone trials with an external DRG stimulator. DRG stimulation has been shown to be successfull in the treatment of CRPS1&2, Chronic Post Surgical Hip, Knee, Foot, Chronic Pelvic, and Post Hernioraghy Pain syndromes.
The Dorsal Root Ganglion Stimulaiton Implantation Process
Implantation of a Dorsal Root Ganglion stimulator is a two-step process that involves first implanting the stimulator, and then a pulse generator to power it. To implant the stimulator, an incision is made in the patient's back; the wires with electrodes on the end are fed through and positioned on the spinal cord. Exact placement depends on the area of pain.
To implant the pulse generator, an incision is made in the buttocks or abdomen, and the generator is placed between layers of skin and muscle. An extension wire is run from the spine to whichever area the generator is placed in.
Incisions are closed with either staples or sutures. The procedure takes 2 tp 4 hours, and the patient usually goes home on the same day.
Recovery from the Dorsal Root Ganglion Stimulator Implantation Process
Pain from DRG stim implantation is treated with prescription medication and/or over-the-counter painkillers. A patient should refrain from lifting, bending, twisting and stretching during the healing process, which can take 6 to 8 weeks.
Risks and Complications of Dorsal Root Ganglion Stimulation
In addition to the risks associated with any surgical procedure, those related to DRG Stim include spinal-fluid leakage and paralysis. Complications related specifically to the stimulator include the following:
- Device works only intermittently or stops
- Device causes over-stimulation or unpleasant sensations
- Stimulation occurs in the wrong place
- Device causes an allergic reaction
It is also possible that the device's wires could shift or become damaged, which might require surgical intervention.
The pulse generator's battery, if it is a standard one, needs to be surgically replaced every 10 years. This device is non rechargeble.
