Best Practices for Dorsal Root Ganglion Stimulation for Chronic Pain: Guidelines from the American Society of Pain and Neuroscience

Kenneth B Chapman; Dawood Sayed; Tim Lamer; Corey Hunter; Jacqueline Weisbein; Kiran V Patel; David Dickerson; Jonathan M Hagedorn; David W Lee; Kasra Amirdelfan; Timothy Deer; Krishnan Chakravarthy

doi:10.2147/JPR.S364370

Best Practices for Dorsal Root Ganglion Stimulation for Chronic Pain: Guidelines from the American Society of Pain and Neuroscience

J Pain Res. 2023 Mar 14:16:839-879. doi: 10.2147/JPR.S364370. eCollection 2023.

Authors

Kenneth B Chapman^{1

2

3}, Dawood Sayed⁴, Tim Lamer⁵, Corey Hunter⁶, Jacqueline Weisbein⁷, Kiran V Patel^{1

2

3}, David Dickerson^{8

9}, Jonathan M Hagedorn¹⁰, David W Lee¹¹, Kasra Amirdelfan¹², Timothy Deer¹³, Krishnan Chakravarthy^{14

15}

Affiliations

¹ The Spine & Pain Institute of New York, New York, NY, USA.
² Department of Anesthesiology, Zucker School of Medicine at Hofstra Northwell, Manhasset, NY, USA.
³ Department of Anesthesiology, NYU Langone Medical Center, New York, NY, USA.
⁴ Department of Anesthesiology, The University of Kansas Medical Center (KUMC), Kansas City, KS, USA.
⁵ Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA.
⁶ Ainsworth Institute of Pain Management, New York, NY, USA.
⁷ Napa Valley Orthopedic Medical Group, Napa, CA, USA.
⁸ Department of Anesthesiology, Critical Care and Pain Medicine, NorthShore University Health System, Evanston, IL, USA.
⁹ Department of Anesthesia & Critical Care, University of Chicago, Chicago, IL, USA.
¹⁰ iSpine Pain Physicians, Maple Grove, MN, USA.
¹¹ Fullerton Orthopedic Surgery Medical Group, Fullerton, CA, USA.
¹² IPM Medical Group, Inc., Walnut Creek, CA, USA.
¹³ The Spine and Nerve Center of the Virginias, Charleston, WV, USA.
¹⁴ Department of Anesthesiology and Pain Medicine, University of California San Diego Health Sciences, San Diego, CA, USA.
¹⁵ VA San Diego Healthcare System, San Diego, CA, USA.

Abstract

With continued innovations in neuromodulation comes the need for evolving reviews of best practices. Dorsal root ganglion stimulation (DRG-S) has significantly improved the treatment of complex regional pain syndrome (CRPS), and it has broad applicability across a wide range of other conditions. Through funding and organizational leadership by the American Society for Pain and Neuroscience (ASPN), this best practices consensus document has been developed for the selection, implantation, and use of DRG stimulation for the treatment of chronic pain syndromes. This document is composed of a comprehensive narrative literature review that has been performed regarding the role of the DRG in chronic pain and the clinical evidence for DRG-S as a treatment for multiple pain etiologies. Best practice recommendations encompass safety management, implantation techniques, and mitigation of the potential complications reported in the literature. Looking to the future of neuromodulation, DRG-S holds promise as a robust intervention for otherwise intractable pain.

Keywords: best practice; chronic pain; dorsal root ganglion; guidelines; neurostimulation.

Publication types

Review