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Comparison of SCS and DRG outcomes in Focal and Widespread Pain: an ACCURATE Sub-study

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Spinal Cord Stimulation (SCS) is an effective treatment of chronic, intractable pain in a variety of neuropathic pain conditions. One challenge associated with SCS consists in the difficulty to selectively target focal pain regions. Dorsal Root Ganglion (DRG) stimulation, by directly modulating the activity of primary sensory neurons, can afford a higher degree of specificity in targeting painful areas. In this study we included chronic pain patients participating in the ACCURATETM study whose pain was either focal (localized ONLY in the foot region) or widespread (covering a large area of the body surface).

The results of this study suggest that DRG stimulation can be more effective than standard SCS in patients that present focal foot pain. The inferior paresthesia coverage from DRG stimulation in subjects with widespread pain is likely due to difficulty of completely covering very wide pain patterns with DRG stimulation. As the pain reduction was not different between the two groups, these results suggest that pain-paresthesia overlap is not as necessary with DRG stimulation. The retrospective nature of this sub-analysis limits the validity of the results and further prospective studies are needed to confirm these findings.

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