Spinal cord stimulation (also known as “SCS”) therapy has been used to combat chronic pain since 1967. The FDA approved spinal cord stimulation in 1989 for the relief of intractable pain in the torso, arms, and legs.
How does spinal cord stimulation therapy work for chronic pain?
SCS works by sending mild electrical pulses to nerves along the spinal column. The pulses interrupt pain signals before they reach the brain. SCS therapy essentially tricks the brain into feeling only numbness or a mild tingling sensation, instead of the constant searing agony of incurable chronic pain.
Currently, the primary use of SCS is to help avoid a back surgery that may prove to be futile. The second most common application of SCS is to alleviate the intolerable pain associated with complex regional pain syndrome (CRPS). SCS is also used to relieve peripheral neuropathic pain related to nerve damage from viral infection, surgery, or diabetes.
But spinal cord stimulation is not a panacea for patients suffering from CRPS or failed back surgery syndrome. For example, more than half of CRPS patients fail to achieve any meaningful pain relief with SCS.
What is dorsal root ganglion stimulation?
In February 2016, the FDA approved a new pain relief technique called dorsal root ganglion (DRG) stimulation. While DRG stimulation is similar to spinal cord stimulation, it varies in significant respects.
- In traditional SCS stimulation, electrodes are placed, and pulses are emitted, along the length of the spinal cord.
- In DRG stimulation, the electrical pulses travel directly to nerve cells known as dorsal root ganglions located on the sides of each vertebra in the spine. Dorsal root ganglions are the sensory gate for pain signals sent to the brain along the spinal cord. DRG stimulation is proved through studies to better disrupt pain signals on their way to the brain.
The FDA approved DRG stimulation from the results of the ACCURATE study
The ACCURATE study was conducted at 22 investigational sites spread across the United States. The study recruited 152 subjects, each of whom had been diagnosed with chronic complex regional pain syndrome in their legs. The participants were randomly placed into two groups. One group received DRG stimulation therapy and the other received standard spinal cord stimulation.
The results of the ACCURATE research are quite impressive. Participants receiving DRG stimulation had a higher rate of treatment success (81.2%). The success rate for traditional SCS was (56.7%). The pain relief from DRG stimulation continued through 12 months of follow-up.
What are the advantages of DRG stimulation over standard SCS stimulation?
- SCS stimulation is sent to the entire spinal column. DRG stimulation is tightly focused on the nerves associated with a specific area of pain. This delivers more effective interruption of pain signals. It also reduces the intensity of the numbness and tingling which replace the pain signals.
- Lower energy requirements. DRG stimulation uses only about 10% of the energy required for traditional SCS. This leads to longer-lasting batteries and correspondingly less need for replacement surgeries.
Dorsal root ganglion stimulation is studied for treatment of chronic back pain
The results of a new study of DRG stimulation and chronic back pain were recently reported at the annual meeting of the American Society of Anesthesiologists in San Francisco. The project was led by Robert McCarthy, PharmD., who is a professor of anesthesiology at Rush University Medical Center in Chicago. McCarthy and his colleagues focused on 67 people who suffered from chronic back pain. The study’s participants were each implanted with a dorsal root ganglion stimulator.
“People in our study who had DRG stimulation reported significant improvement in pain even after a year, which is notable,” said McCarthy. “They had tried numerous therapies, from drugs to spinal cord stimulation to surgery, but got little or no lasting pain relief. For most, DRG stimulation improved their quality of life.”
Before the DRG devices were implanted, many of the participants rated their back pain as an 8 on a scale of 1 to 10. They were followed for 3 to 18 months after the devices were implanted. For most, DRG stimulation reduced their pain by one third. The participants also reported that the limitations on their daily activities were reduced by 27% and 94% said the treatment was beneficial.
Although DRG stimulation therapy was approved by the FDA in 2016, it is still not widely available. According to McCarthy, DRG stimulation therapy is offered only in advanced medical research centers, where doctors are trained in implantation and regulation techniques. Dr. Vadhedifar is highly proficient in these techniques and we offer DRG stimulation therapy at Nuvo Spine.
DRG stimulation is covered by Medicare, and Blue Cross/Blue Shield cover it when it’s deemed to be medically necessary, but not all insurance companies will pay for the procedure. For uninsured patients, the cost can be daunting ($15,000 – $50,000).
Why Nuvo Spine and Sports is your best choice for pain management
We approach our work armed with tried and true medical techniques and state-of-the-art regenerative strategies bred from sports medicine and the neurological sciences.
The Nuvo team of medical professionals is solely dedicated to minimizing or eradicating pain by resolving the underlying conditions that cause the pain. We are proud that we consistently achieve that goal and successfully enhance our patients’ overall quality of life.
To request more information or schedule a consultation, please call (888) 370-9334 or make your appointment online.
Read the full article at: www.chicagotribune.com
Dr. Vahedifar's pain management strategies integrate cutting-edge medical technology with targeted interventions to minimize pain and treat pain’s underlying causes.
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