Dorsalganglienstimulation in der Neuromodulation – Evidenz, Indikationen und klinische Anwendung
摘要
Dorsal root ganglion stimulation (DRGS) has become established as a specialized neuromodulation technique for focal neuropathic pain syndromes, such as complex regional pain syndrome (CRPS), peripheral nerve injuries as well as groin and knee pain. It enables targeted segmental coverage, selective stimulation of hard to reach dermatomal areas and improves daily functioning and treatment adherence.
ObjectiveThe aim of this work is to present the current evidence on DRGS, analyze its clinical fields of application and evaluate its effectiveness, safety, quality of care, and economic aspects.
Material and methodsA review of the relevant literature was conducted, including randomized controlled trials (RCTs), reviews, cohort studies and clinically significant case reports. Key outcomes assessed included pain reduction, function, quality of life, patient selection, technique, adverse events and the cost-benefit ratio.
ResultsThe results of RCTs confirm response rates ≥ 50% and a pain reduction >80% in CRPS and similar pain conditions. Observational studies confirm sustained effects, improved quality of life and reduced medication dependency. The infection rates range between 2–5%. The electrodes for DRGS can be placed with high precision. Advantages include low stimulation amplitudes, high energy efficiency and stable therapeutic effects.
ConclusionThe DRGS is an evidence-based, selective treatment option with high therapeutic potential for focal neuropathic pain. It offers high response rates, functional improvements and a favorable safety profile. Technical innovations and expanded indications further enhance the clinical utility. Critical factors remain careful patient selection, structured follow-up and further studies on long-term efficacy and cost-effectiveness.