Impact of lowering frequency of dorsal root ganglion stimulation on implantable pulse generator consumption

• Published in: Regional anesthesia and pain medicine Vol. 48; no. 1; pp. 44 - 45
• Main Authors: Chapman, Kenneth B, Tupper, Connor J, Amireh, Ahmad A, van Helmond, Noud, Yousef, Tariq A
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.01.2023; BMJ Publishing Group LTD
• Subjects: CHRONIC PAIN; Diabetic neuropathy; Electric stimulation therapy; Ganglia, Spinal - physiology; Humans; Pain Management; Patients; Regional anesthesia; Research report; Spinal cord; Spinal Cord Stimulation; TECHNOLOGY; United States > US; New York; Spinal Cord Stimulation; CHRONIC PAIN; TECHNOLOGY; Pain Management
• ISSN: 1098-7339; 1532-8651
• DOI: 10.1136/rapm-2022-103644

Introduction Dorsal root ganglion stimulation (DRG-S) is a recent advancement in neuromodulation for chronic pain that is superior to spinal cord stimulation in the treatment of complex regional pain syndrome.1 2 Recent studies have shown that dose-tapering strategies for DRG-S using very low frequencies can provide equivalent therapeutic efficacy to standard program settings.3 4 Lower charge output requirements for DRG-S should also result in increased battery life. No patients underwent IPG replacement during the study.Table 1 Demographic and clinical characteristics, stimulation settings, and remaining IPG charge by stimulation strategy Standard programming Dose tapered Total Demographic and clinical characteristics Patients, n 16 90 106 Age in years, mean±SD 55±11 61±13 60±13 Sex, male/female, n (%) 3/13 (19/81) 34/56 (38/62) 37/69 (35/65) Primary diagnosis, n (%) Failed back surgery syndrome 10 (63) 40 (44) 50 (47) Non-surgical low back pain 3 (19) 22 (24) 25 (24) Complex regional pain syndrome 2 (13) 9 (10) 11 (10) Nociceptive joint pain 0 (0) 5 (6) 5 (5) Abdominal/pelvic pain 1 (6) 6 (7) 7 (7) Radiculopathy 0 (0) 3 (3) 3 (3) PVD/PDN 0 (0) 3 (3) 3 (3) Ilioinguinal pain 0 (0) 1 (1) 1 (1) Intercostal pain 0 (0) 1 (1) 1 (1) Dorsal root ganglion stimulation level Patients with leads at level, n (%)* C6 0 (0) 1 (1) 1 (1) C7 0 (0) 4 (4) 4 (4) C8 0 (0) 3 (3) 3 (3) T1 0 (0) 1 (1) 1 (1) T9 0 (0) 1 (1) 1 (1) T11 0 (0) 2 (2) 2 (2) T12 14 (88) 77 (86) 91 (86) L1 1 (6) 11 (12) 12 (11) L2 1 (6) 2 (2) 3 (3) L3 0 (0) 5 (6) 5 (5) L4 2 (13) 11 (12) 13 (12) L5 0 (0) 7 (8) 7 (7) S1 0 (0) 7 (8) 7 (7) S2 0 (0) 5 (6) 5 (5) S3 1 (6) 0 (0) 1 (1) Stimulation settings Stimulation frequency, mean 19.1 Hz 6.9 Hz 8.7 Hz Stimulation pulse width, mean 259 µs 257 µs 257 µs Stimulation amplitude, mean 0.492 mA 0.567 mA 0.557 mA Stimulation charge/second, mean 2.434 μC/s 1.005 μC/s 1.245 μC/s Remaining charge Therapy duration, mean 1 year 8 months (603 days) 1 year 10 months (671 days) 1 year 10 months (661 days) Remaining IPG charge, mean 2.978 V 2.988 V 2.987 V Charge remaining at ≥3.00 V, n (%) 1 (6) 35 (39) 36 (34) *Percentages summate to >100% due to patients typically receiving leads at multiple levels. Factors used to estimate IPG life expectancy are frequency, pulse width, amplitude, impedance, and number of leads.