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For the Neuromodulation Team at Oxford University Hospitals, 2016 has had an electrifying start. The team have been performing dorsal root ganglion (DRG) stimulation since 2013 and were one of the first UK centres to perform the procedure.

Dr Jeff Kramer from St Jude Medical talking about the physiology of DRG stimulation
Dr Jeff Kramer from St Jude Medical talking about the physiology of DRG stimulation

The technique is used to treat chronic, intractable pain and involves the placing of a stimulating electrode over the DRG, a small enlargement of the nerve as it enters the spine. This is done with the patient awake via an epidural puncture and the lead is steered into position under X-ray control.

Tip Lead Delivery System“This treatment is a game-changer and early results suggest that not only do we get more pain relief than traditional spinal cord stimulation in some patient groups, but we are able to treat people with conditions such as complex regional pain syndrome and post-surgical pain such as hernia repair, that we used to struggle to successfully treat” says Mr James Fitzgerald, a Consultant Neurosurgeon from the Nuffield Department of Surgical Sciences and one of the surgeons involved.

The Oxford team have been involved with a variety of clinical research, designed to support the current indications, and to investigate the effect the therapy has on new groups of patients who don’t currently have a treatment option. This has led to the team successfully treating some world first patient indications with the therapy.

The DRG Masterclass was a three-day international course aimed at introducing the American physicians to the technique (prior to FDA approval) and to hone the skills of the UK practitioners. The course involved cadaver sessions where attendees had the chance to practice their skills on human bodies, based at the University of Oxford’s Department of Physiology, Anatomy and Genetics. There were lectures and also a morning of live surgeries performed in the Neurosurgical Theatres at the John Radcliffe Hospital and watched by the participants from a lecture theatre.

The course was supported by St Jude Medical (SJM), manufacturers of the electrodes. Clair Jackson, Therapy Development Manager at SJM, said: “Oxford is one of the leading centres globally for DRG both in terms of research and teaching. Mr Alex Green and Mr James Fitzgerald have convened a highly successful course and we have received excellent feedback from the participants. We would also like to thank the Advanced Nurse Practitioners in the team; Liz Moir, Karen Dawson, Claire Camidge and Rodrigo Ortega Garcia for their expertise in programming the electrodes”.

The image above shows a DRG lead that is inserted into a patient's spine.

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