DRG stimulation is a stimulation modality that’s similar to spinal cord stimulation in that you always get a temporary trial first for a week before you proceed with a permanent implant. The difference is that the hardware is smaller in diameter, so the electrodes are just a millimeter in diameter, and they’re placed along the early portion of the nerve root just as it’s exiting the spine.

And this is the one area of the nervous system where all the sensory fibers, all those nerve fibers that transmit pain sensation and other sensation, are coalesced together and packed together, and we’re able to stimulate all the sensory fibers with this electrical stimulation device. And so an electrode with four separate contacts is placed along that nerve root, initially for a temporary trial period for a week, to stimulate the painful area of the extremity.

And as I mentioned before, it is a more effective stimulation modality when it’s compared head-to-head with spinal cord stimulation. And so once you respond to the temporary trial, then two weeks later you get a permanent implant, where I, as an interventional pain physician, would make an incision, one at each level for the electrodes to be inserted, and then a separate incision where the electrodes are connected to an implanted pulse generator battery that then drives the system to provide sustained, long-term pain relief.

This is something that can be removed at a later point in time if desired, just like spinal cord stimulation, so there is that reversibility aspect to it. But it is a minimally invasive procedure. In order to make the incisions for the electrodes, they’re usually a three-quarter inch incision at either of the electrode levels that you’re going to position. Let’s say, hypothetically, in the low back, for the L4 or the L5 lead, that’s a common application for somebody who’s having lower leg or foot pain. And then you make a separate two-inch incision in the low back to connect the electrodes.

These are all done as an outpatient procedure, and within one to two weeks you’re recovered from that procedure. And then you need to go through a course of physical therapy or occupational therapy in order to upgrade your functional status, because once you’ve cut this pain down in half, one needs to improve your ability to walk. Many times, people have adopted an abnormal gait pattern because of the nature of the pain, so you need to go through that physical exercise training in order to improve your ability to walk for longer time frames and the like.

This has been a very gratifying treatment modality in order to improve patients’ lives, because we have these advances in our armamentarium of pain treatment options now, much more so than when I was in the early part of my career, that can make a meaningful difference in someone’s lives.

And so when you take that type of individual who feels like there’s no hope and you then apply this treatment of DRG stimulation, and you get them back to a point where they can jump back into life again. And so I’ve seen people get back and finish their training and education, social lives improve, and then move on with the other aspects of their lives.

And so that’s so very gratifying to see that you’ve been able to make a difference in someone’s life before that they simply didn’t have any real hope.