DORSAL ROOT GANGLION STIMULATOR (DRG)
What Is DORSAL ROOT GANGLION?
The DRG (dorsal root ganglion) is a bundle of nerve cells located at the side of the spine, where the spinal nerve root exits becoming a peripheral nerve.
What does the procedure look like?
Often before a permanent procedure is performed, a trial procedure is done to determine the effectiveness of the treatment with the patient. This trial typically lasts 5 to 7 days. To connect the trial stimulator, leads are temporarily implanted through the skin and using an epidural needle are placed into the epidural space. The leads are then positioned within the epidural space and the physician then stimulates the dorsal root ganglion. The physician will determine which particular DRG targets to stimulate based on the location of the patient’s pain. When the leads are properly placed, they are then connected to an external trial stimulator battery.
Throughout the trial, patients are able to control their device to alleviate pain. The patient is able to turn the device on and off as needed, and can adjust the stimulation up or down for comfort. The implant is programmed with multiple different programs they can use to help eliminate pain.
At the conclusion of the trial, the temporary leads will be removed and the patient and physician will determine if a permanent device should be implanted.
If the physician determines that the trial was successful, a permanent stimulator may be implanted.
Two small incisions are made to complete the procedure and permanent leads are implanted into the predetermined location in the epidural space. The leads are then connected to a computer/battery unit called the internal pulse generator (IPG). Once the leads are connected, the IPG unit is implanted into the upper buttock region. This takes around 30-40 minutes to complete. When the procedure is completed, the IPG is programmed with an external control unit given to the patient to control the system. The patient is then instructed on how to utilize the control unit and adjust the settings on the IPG. Once the patient is instructed they are released.
WHAT IS INTRACEPT?
The Intracept procedure is a minimally invasive procedure performed on the basivertebral nerve. This is a nerve located in the vertebrae. The basivertebral nerve is responsible for applying innervation to the end plates of the vertebral body. When the Intracept probe burns that nerve, pain signals are blocked from reaching the vertebral plates.
What does the procedure look like?
To perform the procedure, the physician inserts a specialized probe into the vertebrae through a small incision in the lower back. The incision is 5-6 millimeters, no larger than the Intracept probe. Once the probe is positioned at the the basivertebral nerve, the nerve is disabled with radiofrequency energy (heat). This process is known as basivertebral nerve ablation.
The basivertebral nerve is responsible for applying innervation to the end plates of the vertebral body. When the Intracept probe burns that nerve, pain signals are blocked from reaching the vertebral plates.
Intracept is a minimally invasive, outpatient procedure. This means the recovery period is rapid, the patient often recovering within days. The procedure requires no implants or augmentation to the spine’s structure. Due to the minimally invasive nature of the Intracept procedure, the patient is usually able to resume normal life with immediate pain relief.