TY - JOUR
T1 - Dorsal root ganglion stimulation device explantation
T2 - A multicenter pooled data analysis
AU - Chapman, Kenneth B.
AU - Yang, Ajax
AU - Mogilner, Alon Y.
AU - Mandelberg, Nataniel
AU - Patel, Kiran V.
AU - Lubenow, Timothy
AU - Deer, Timothy
AU - Kallewaard, Jan Willem
AU - van Helmond, Noud
N1 - Funding Information:
Jan Willem Kallewaard is on the advisory board Abbott, Saluda, Nevro, Boston Scientific. Timothy Deer is a consultant for Abbott, Medtronic, Boston Scientific, Nevro, Nalu, Saluda. He has equity in Saluda, SPR, Spinethera, Nalu, Cornerloc, Paintec and Vertos. Research funding with Boston Scientific, Abbott, Saluda. Alon Mogilner is a consultant for Abbott Medical and Medtronic, and has received fellowship funding from Abbott and Medtronic. Timothy Lubenow is a consultant for Abbott, Boston Scientific, Medtronic, Nevro, Avanos, and Flowonix. Research funding with Abbott, Boston Scientific, and Nevro. Kenneth Chapman, Ajax Yang, and Noud van Helmond have nothing to disclose.
Publisher Copyright:
© 2022 World Institute of Pain.
PY - 2022/6
Y1 - 2022/6
N2 - Introduction: Dorsal root ganglion stimulation (DRG-S) is a relatively new neuromodulation modality. Therefore, data on long-term device explantation rates is limited. This investigation aimed to assess DRG-S device explantation rates at long-term follow-up. Methods: We retrospectively reviewed individuals implanted with DRG-S in four pain centers from different continuous periods between April 2016 to September 2020. We recorded patient demographics, diagnoses, duration to explantation or last follow-up, treatment complications, and failure etiologies. Results: A total of 249 patients with 756 leads and a mean 27-month follow-up were included. The mean age was 55 ± 15 years; 148 (63%) were female. Leading diagnoses were CRPS (n = 106, 43%), followed by FBSS (n = 64, 26%), and non-surgical low back pain (n = 23, 9%). The explantation rate was ~2% per year (n = 10 total). At explantation, the average time from implantation was 13 ± 10 months. Six patients were explanted for inadequate pain relief. Two patients were explanted due to device-related complications. One patient was explanted secondary to infection and subsequently reimplanted. Five explanted patients experienced a therapy-related complication before eventual explantation: one transient post-procedural neuritis and pocket site pain, one lead fracture, two lead migrations, and one experienced a fracture, a migration, and pocket site pain. Discussion: This large retrospective study of DRG-S revealed a low therapy-termination rate. The rate of infection leading to explantation was objectively very low at 0.4%. The leading cause of explantation was inadequate pain relief. Explanted patients often had a therapy-related complication. Therefore, minimizing adverse treatment events may reduce ultimate explantation rates.
AB - Introduction: Dorsal root ganglion stimulation (DRG-S) is a relatively new neuromodulation modality. Therefore, data on long-term device explantation rates is limited. This investigation aimed to assess DRG-S device explantation rates at long-term follow-up. Methods: We retrospectively reviewed individuals implanted with DRG-S in four pain centers from different continuous periods between April 2016 to September 2020. We recorded patient demographics, diagnoses, duration to explantation or last follow-up, treatment complications, and failure etiologies. Results: A total of 249 patients with 756 leads and a mean 27-month follow-up were included. The mean age was 55 ± 15 years; 148 (63%) were female. Leading diagnoses were CRPS (n = 106, 43%), followed by FBSS (n = 64, 26%), and non-surgical low back pain (n = 23, 9%). The explantation rate was ~2% per year (n = 10 total). At explantation, the average time from implantation was 13 ± 10 months. Six patients were explanted for inadequate pain relief. Two patients were explanted due to device-related complications. One patient was explanted secondary to infection and subsequently reimplanted. Five explanted patients experienced a therapy-related complication before eventual explantation: one transient post-procedural neuritis and pocket site pain, one lead fracture, two lead migrations, and one experienced a fracture, a migration, and pocket site pain. Discussion: This large retrospective study of DRG-S revealed a low therapy-termination rate. The rate of infection leading to explantation was objectively very low at 0.4%. The leading cause of explantation was inadequate pain relief. Explanted patients often had a therapy-related complication. Therefore, minimizing adverse treatment events may reduce ultimate explantation rates.
UR - https://www.scopus.com/pages/publications/85129424538
U2 - 10.1111/papr.13113
DO - 10.1111/papr.13113
M3 - Article
C2 - 35429364
SN - 1530-7085
VL - 22
SP - 522
EP - 531
JO - Pain practice
JF - Pain practice
IS - 5
ER -