Dorsal root ganglion stimulation combined with spinal cord stimulation for effective treatment of postherpetic neuralgia - A case report -

BACKGROUND: Although spinal cord stimulation (SCS) can be a treatment option for intractable postherpetic neuralgia (PHN), obtaining proper stimulation at the thoracic dermatome is difficult. Dorsal root ganglion (DRG) stimulation may be an effective treatment for patients with insufficient efficacy in SCS only. CASE: A 54-year-old male with intractable PHN was referred to our clinic. Pain was localized to the distribution of the T1–3 dermatomes. SCS trial was conducted, and lead was placed within the epidural space over the C6–T1 level; however, the stimulation was inadequate for his pain site. Therefore, another lead was placed within the left T1 and T2 DRG for trial, and T1 DRG stimulation provided adequate stimulation. T1 DRG stimulation and SCS could cover the entire pain site with paresthesia, and his pain was decreased by over 50%. CONCLUSIONS: DRG stimulation combined with SCS may be a good treatment option for intractable thoracic PHN.