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Dorsal root ganglion stimulation for treatment of chronic postsurgical pain secondary to triple neurectomy
Journal article   Open access

Dorsal root ganglion stimulation for treatment of chronic postsurgical pain secondary to triple neurectomy

Anishinder Parkash, Joe H. Ghorayeb, Isaiah Levy, Aman Upadhyay, Suresh Srinivasan and Gaurav Chauhan
Interventional Pain Medicine (Online), v 2(1), 100245
01 Mar 2023
DOI: https://doi.org/10.1016/j.inpm.2023.100245
PMID: 39239604
url
https://doi.org/10.1016/j.inpm.2023.100245View
Published, Version of Record (VoR) Open

Abstract

Chronic pain syndrome Chronic post-surgical pain Dorsal root ganglion stimulation Inguinal pain Spinal neuromodulation Triple neurectomy
Triple neurectomy (resection of Ilioinguinal, Iliohypogastric, and Genitofemoral nerves) is performed in cases of inguinal neuralgia, refractory to conservative management. However, this procedure comes with several adverse effects, including but not limited to ectopic afferent firing and tactile allodynia. In such a scenario, the inguinal pain can become chronic and debilitating and can be classified as chronic post-surgical pain. Spinal neuromodulation techniques have been employed for treating such refractory, intractable chronic groin, pelvic and abdominal pain. One such technique is dorsal root ganglion stimulation which is designed to manage difficult-to-treat chronic pain in specific areas of the lower body, such as the foot, knee, hip, or groin. The authors present a case in which the patient underwent a laparoscopic neurectomy of ilioinguinal, Iliohypogastric, and genitofemoral nerves that failed to resolve her pain-related symptoms. The patient presented to the authors’ pain clinic with severe inguinal pain and allodynia, refractory to multiple analgesic agents. The patient underwent a successful trial and subsequent implant with ipsilateral dorsal root ganglion stimulation at L1& L2. At six months post-implant, the patient continues to report 80–90% improvement in her pain and physical function.

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