Dorsal Root Ganglion Stimulator (DRGS)

Chronic pain is burdensome and even more so for the individual patients who have exhausted various modalities of treatment with minimal to no success. These treatments include, but are not limited to physical therapy, prescription medications, nerve blocks, medial branch blocks, epidural injections, radiofrequency ablation, intrathecal pain pumps, spinal cord stimulators, or surgical interventions. However, at Solutions In Pain we offer these treatment resistant patients the implantation of cutting edge medical devices such as the Dorsal Root Ganglion Stimulator (DRGS). Please note that while similar to the SCS the DRGS is fundamentally different as it provides a more highly specific or focal targeting of chronic pain.
Indications For DRG:

• Neuropathic pain after surgical procedures (Causalgia)
• Hernia repair
• Total knee and hip replacements
• Foot and ankle surgery
• Pelvic pain after surgery or trauma
• Lower extremity amputations
• Causalgia from a traumatic injury of the hip, knee, ankle or foot
• CRPS I of the lower extremities

Chronic pain like all pain is reliant on the intimate communication between the nerves and our brain. However, these pain signals that travel along the nerves in our spine & body can be treated with excellent precision & efficacy by interrupting or blocking the communication of pain signals associated with chronic back pain. Therefore our clinic through the courtesy of cutting edge medical device companies offers the the surgical implantation of a Dorsal Root Ganglion Stimulator (DRGS): a pace-maker like device that is implanted under the skin which through neuromodulation is able to deliver mild electrical impulses which can substantially reduce the pain of thus suffering from chronic pain. Moreover, the device has remote control capabilities allowing patients to control their pain with remarkable precision using the flexible intensity & location parameters of the device.

What To Expect From Your Procedure
A. Preoperative Phase
We will perform preoperative assessment and order psychiatric clearance at which point you will be referred to a psychiatrist who will evaluate your medical history, family history, psychological history, and history of substance abuse if relevant. Furthermore, the psychiatrist will ask you questions regarding your chronic pain, how it impacts your everyday life, and how the pain has affected you both physically & emotionally.

B. Trial Phase
You will arrive at our clinic 15-30 minutes prior to your appointment with a designated driver where we will educate you at length on the benefits & risks of the procedure. After this discussion we will then have you sign a consent form as well as other necessary documentation and you will subsequently be positioned in preparation for the procedure.

The procedural site will be prepared in an antiseptic manner with administration of local anesthetics and you will be lightly sedated. The trial stimulator leads will then be temporarily implanted percutaneously (*through the skin) using an epidural needle placed into the epidural space (*the area surrounding the spinal cord). Once the leads are positioned within the epidural space, your provider will then stimulate the dorsal root ganglion, instead of the spinal cord. The dorsal root ganglion is located at the side of the spine where the spinal nerve root exits to become a peripheral nerve. Your provider will know which DRG targets to stimulate based on the exact location of your pain. Once the leads are properly placed, they are then connected to an external battery and programmer. You will then be observed for an additional 10-15 minutes following completion of the procedure to ensure your safety. After you have been monitored you will then be provided device use/care as well as wound care discharge instructions from your provider along with a prescription for a short course prophylactic antibiotic. Following discharge education you will then be scheduled for postoperative follow up by our staff. Trial phase is 5-7 days in duration.

C. Implantation Phase
At the date of your postoperative follow up visit you will be thoroughly evaluated regarding your experiences with respect to the trial phase. If you had positive experiences with substantial pain relief during the trial phase we will recommend proceeding with the implantation phase. At which point you may decide whether or not to move forward with permanent implantation at our surgical center.

You will arrive at the surgical center 15-30 minutes prior to your appointment with a designated driver where we will educate you at length on the benefits & risks of the procedure. After this discussion we will then have you sign a consent form as well as other necessary documentation and you will subsequently be positioned in preparation for the procedure.

The procedural site will be prepared in an antiseptic manner with administered local anesthetics and you will be lightly sedated. Two small incisions are then made at which point permanent leads are implanted through the predetermined location in the epidural space. Next, the leads are connected to the computer/battery unit called the internal pulse generator (IPG). Once the leads are connected, the IPG is implanted in the upper buttock region. The procedure takes around 30-40 minutes to complete. You will then be observed for an additional 10-15 minutes following completion of the procedure to ensure your safety. After you have been monitored you will then be provided device use/care as well as wound care discharge instructions from your provider along with a prescription for a short course prophylactic antibiotic. Following discharge education you will then be scheduled for postoperative follow up by our staff.

The Advantages Of Our Dorsal Root Ganglion Stimulator (DRGS) Devices
Our clinic carries the most advanced neuromodulation technologies which offer incredible benefits when compared to other medical devices on the market. Including, but not limited to:

• Recharge Free:

Unlike other DRGS devices that require frequent charging sessions to maintain pain relief our clinic offers devices with a battery that lasts up to 6.5 years (*nominal settings) without ever needing to be charged

• Low Energy Therapy:

Unlike other DRGS devices which can often produce a tingling feeling that can be uncomfortable for patients our clinic offers devices which mimic natural patterns found in the brain effectively eliminating or reducing this tingling sensation while maintaining optimal pain relief

• MRI Compatible:

Unlike other DRGS devices which can be incompatible with medical imaging techniques our clinic offers devices which are compatible with a variety of medical imaging techniques including MRI.