Targeted Nerve Root Stimulation Alleviates Intractable Chronic Limb Pain Associated with Complex Regional Pain...

Area of Science:

• Neurology
• Pain Medicine
• Biomedical Engineering

Background:

• Limited therapeutic options exist for complex regional pain syndrome (CRPS).
• Spinal cord stimulation and dorsal root ganglion stimulation are established treatments for CRPS lower limb pain.
• Evidence for dorsal nerve root stimulation in CRPS lower limb pain is limited.

Purpose of the Study:

• To assess the efficacy of electrical stimulation of dorsal nerve roots via epidural lead placement for chronic lower limb pain in CRPS patients.
• To demonstrate pain relief in patients suffering from CRPS.

Main Methods:

• Prospective, open-label, single-arm, multi-center study involving 16 patients with intractable CRPS lower limb pain.
• A 3-10 day trial of dorsal nerve root stimulation was conducted.
• Patients achieving ≥50% pain relief proceeded to permanent neurostimulator implantation, followed for 6 months.

Main Results:

• Significant pain reduction (3.3 points on NRS, P = 0.0006) at 3 months.
• Sustained improvements in quality of life, neuropathic pain, and patient satisfaction up to 6 months.
• The therapy demonstrated functionality, effectiveness, and safety.

Conclusions:

• Dorsal nerve root stimulation is a viable treatment for intractable lower limb pain in CRPS.
• The study confirmed the effectiveness and safety of intraspinal stimulation using conventional systems and parameters.
• Despite COVID-19 limitations, the feasibility study shows promising results for this therapeutic approach.