Endoscopic Lateral Approach for Dorsal Root Ganglion Burst Stimulation: Technical Note and Illustrative Case Series

Area of Science:

• Neurosurgery
• Pain Management
• Minimally Invasive Procedures

Background:

• Dorsal root ganglion (DRG) stimulation offers superior pain relief and quality of life improvements compared to traditional spinal cord stimulation.
• Implanting DRG leads can be challenging in patients with prior spinal surgery due to epidural scarring and lead stiffness.
• Recurrent radiculopathy after spinal surgery is a potential indication for DRG stimulation.

Purpose of the Study:

• To present a novel technique for DRG stimulation lead placement.
• To investigate the feasibility of percutaneous transforaminal lead insertion using an endoscopic approach.
• To combine DRG stimulation with burst mode for enhanced pain relief.

Main Methods:

• Percutaneous transforaminal placement of cylindrical leads.
• Utilizing a lateral endoscopic approach for lead insertion.
• Application of burst stimulation in conjunction with DRG lead placement.

Main Results:

• Successful percutaneous transforaminal lead placement was demonstrated in three patients.
• The novel endoscopic approach proved feasible for DRG lead implantation.
• The technique is suitable for patients with previous spinal surgery and epidural scarring.

Conclusions:

• A novel endoscopic lateral transforaminal approach facilitates DRG lead insertion.
• Cylindrical leads are compatible with burst stimulation devices for DRG application.
• This combined approach offers a new strategy for managing complex radicular pain.