Dorsal Root Ganglion Stimulation for Chronic Postoperative Pain Following Thoracic Surgery: A Pilot Study. Issue 4 (9th September 2020)

• Record Type: Journal Article
• Authors: Lo Bianco, Giuliano; Papa, Alfonso; Gazzerro, Giuseppe; Rispoli, Marco; Tammaro, Dario; Di Dato, Maria Teresa; Vernuccio, Federica; Schatman, Michael
• Is Part Of: Neuromodulaton. Volume 24:Issue 4(2021)
• Page Start: 774
• Page End: 778
• Publication Date: 2020-09-09
• Subjects: Chronic pain -- nerve block -- postoperative pain -- spinal ganglia -- thoracic surgery; Central nervous system -- Physiology -- Periodicals; Central nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ner.13265
• Languages: English
• ISSNs: 1094-7159

Abstract

Abstract: Objectives: Post‐thoracotomy pain syndrome (PTPS) is defined as persistent pain following a thoracotomy and has an incidence of 21–61%. Dorsal root ganglion stimulation (DRG‐S) is a form of neuromodulation that modulates pain signal transmission to the spinal cord. The aims of this study were to investigate the efficacy of DRG‐S for the management of PTPS and to assess the role of thoracic paravertebral blocks (t‐PVB) as a tool for prediction of success of DRG‐S. Materials and Methods: In this prospective study, we included all patients undergoing thoracic surgery, with PTPS not responding to pharmacotherapy and treated with DRG‐S from September 2018 to February 2019. t‐PVB followed by a percutaneous DRG‐S trial was performed on all patients. Pain intensity was assessed through a numeric rating scale (NRS) and Douleur Neuropathique en 4 Questions (DN4) at baseline, post‐trial, at 14 days, 90 days, and at one year after DRG‐S implantation. Data summarized as continuous variables were expressed as means and standard deviations (SDs), and categorical variables were expressed as raw numbers and percentages. Results: Four patients out of 51 who underwent thoracic surgery at our institution surveyed were included (mean age ± SD, 56 ± 16 years old). Mean NRS and DN4 were, respectively, 7.2 ± 0.96 SD and 8.2 ± 0.5 SD at baseline, 2.5 ± 0.6 SD and 3.2 ± 0.5 SD after t‐PVB, 2.2 ± 0.5 SD and 2.2 ± 0.5 SD at 14 days, 90 days, and at one year after DRG‐S implantation. No complications or side effects were reported. Conclusions: Our preliminary results show that DRG‐S is an effective therapy for PTPS after thoracic surgery. In addition, thoracic paravertebral blocks performed prior to DRG‐S correlated with a positive outcome with treatment.