Char Steven, Barman Ross A, Deer Timothy R, Hagedorn Jonathan M
Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ, USA.
Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA.
Neuromodulation. 2022 Oct;25(7):965-969. doi: 10.1111/ner.13468. Epub 2022 Jun 14.
Chronic neuropathic groin pain develops in a significant number of postsurgical patients; however, multiple etiologies have been identified, and this makes it a challenging condition to treat. While treatment often involves a multimodal approach, advancements in neuromodulation technology, particularly dorsal root ganglion (DRG) stimulation, have benefited patients plagued by chronic pain refractory to standard treatment modalities. Our goal was to provide a definitive source of information for interventional pain physicians regarding groin pain and the use of DRG stimulation for its treatment.
In this narrative review, we provide an overview of groin pain and discuss potential pain generators. We also outline appropriate treatment options with particular interest on DRG stimulation. Lastly, we provide a narrative review of the published literature regarding DRG stimulation for chronic groin pain from a variety of etiologies.
DRG stimulation has emerged as an alternative neuromodulatory technique for patients with chronic groin pain. While previous studies suggest substantial sustained pain relief with DRG stimulation in this patient population, prospective randomized controlled studies are necessary before formal recommendations can be made.
相当多的术后患者会出现慢性神经性腹股沟疼痛;然而,已确定多种病因,这使其成为一种难以治疗的病症。虽然治疗通常采用多模式方法,但神经调节技术的进步,特别是背根神经节(DRG)刺激,使受标准治疗方式难以治愈的慢性疼痛困扰的患者受益。我们的目标是为介入疼痛科医生提供有关腹股沟疼痛以及使用DRG刺激进行治疗的确切信息来源。
在这篇叙述性综述中,我们概述了腹股沟疼痛并讨论了潜在的疼痛产生源。我们还特别关注DRG刺激,概述了适当的治疗选择。最后,我们对已发表的关于针对各种病因的慢性腹股沟疼痛进行DRG刺激的文献进行了叙述性综述。
DRG刺激已成为慢性腹股沟疼痛患者的一种替代性神经调节技术。虽然先前的研究表明DRG刺激能使该患者群体的疼痛得到显著持续缓解,但在做出正式推荐之前,有必要进行前瞻性随机对照研究。