Dorsal Root Ganglion Stimulation Normalizes Measures of Pain Processing in Patients with Chronic Low‐Back Pain: A Prospective Pilot Study using Quantitative Sensory Testing

• Published in: Pain practice 2021-06, Vol.21 (5), p.568-577
• Main Authors: Chapman, Kenneth B., Roosendaal, Bert‐Kristian, Yousef, Tariq A., Vissers, Kris C., Helmond, Noud
• Format: Article
• Language: English
• Subjects: Adult; Aged; chronic low‐back pain; Chronic Pain - diagnosis; Chronic Pain - therapy; conditioned pain modulation; dorsal root ganglion stimulation; Ganglia, Spinal; Humans; Low Back Pain - diagnosis; Low Back Pain - therapy; Middle Aged; pain processing; Pain Threshold; Pilot Projects; Prospective Studies; quantitative sensory testing
• ISSN: 1530-7085; 1533-2500
• DOI: 10.1111/papr.12992

Background Dorsal root ganglion stimulation (DRG‐S) is used as a treatment for chronic low‐back pain (CLBP), although its underlying mechanisms remain elusive. CLBP patients have been found to have reduced mechanoreceptive perception, reduced endogenous analgesia, as well as deep‐tissue hyperalgesia when compared with healthy controls. Using quantitative sensory testing (QST), we studied if DRG‐S in CLBP patients results in changes in pain processing. Methods Quantitative sensory testing was performed in patients before trial implantation of a DRG‐S system for CLBP and just before the trial lead removal or at 1‐month follow‐up after the permanent implant. We determined the pressure pain threshold (PPT) and mechanical detection threshold (MDT) at the most painful lower‐back location. PPT was also measured on the contralateral shoulder as a control. We obtained a measure of endogenous inhibitory pain modulation using conditioned pain modulation (CPM). Results We enrolled 11 patients (60 ± 16 years). Pain decreased from 8.5 ± 1.0 at baseline to 2.0 ± 1.5 on a 0‐10 numerical rating scale with DRG‐S (P