Comparison between spinal cord stimulation and dorsal root ganglion stimulation in the treatment of refractory Complex Regional Pain Syndrome.

Teresa Neves da Rocha Correia1, Daniel Fernandes Silva Marques1, Beatriz do Nascimento Garcia Moreno1, Blenda Antunes Cacique Curcino de Eça1, Lorena Silva dos Reis1, Maria Clara Rêgo de Araújo1

  1. Medicine students at Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.

OBJECTIVE: To compare the therapeutic effectiveness between spinal cord stimulation (SCS) and dorsal root ganglion (DRG) stimulation for refractory Complex Regional Pain Syndrome (CRPS).

METHODS: The present study is a literature review. The descriptors were surveyed on the DeCS portal. The search for scientific articles was made on the PubMed platform, without applying filters and using the formula: (((((((Complex Regional Pain Syndromes) OR (Reflex Sympathetic Dystrophy)) OR (Causalgia)) OR (CRPS)) AND (Spinal Cord Stimulation)) OR (SCS)) AND (Dorsal Root Ganglion Stimulation). Studies which did not match the objective of this review were excluded after the analyzes of the title and the abstract.

RESULTS: The search resulted in 128 articles and 6 of them were selected. Two studies reported a higher percentage of pain relief and a greater stability of the analgesic effect in DRG stimulation compared to SCS. A cohort verified patients’ preference for DRG stimulation compared to SCS. A series of cases demonstrated effective use of SCS combined with DRG stimulation for patients with CRPS who did not obtain satisfactory pain relief only with SCS coverage. Case reports have shown that DRG stimulation was effective in patients refractory to SCS.

CONCLUSIONS: For patients with refractory CRPS, the concomitant use of the methods demonstrated superior pain relief compared to the use of SCS alone. Meanwhile, exclusive DRG stimulation compared to SCS offers a higher percentage of pain relief and sustains the analgesic effect for a longer period.

KEYWORDS: Complex Regional Pain Syndrome; Spinal cord stimulation; Dorsal root ganglion stimulation.