The lumbar dorsal root ganglia (DRG) contain the cell bodies of primary sensory neurons supplying the lower limb and lumbosacral regions, located in the intervertebral foramina at each lumbar level. The DRG is encircled by the epidural fat and lies just proximal to the dorsal root entry zone at the lateral recess. It receives blood supply from the radicular arteries and is highly metabolically active.
The lumbar DRG is the target of dorsal root ganglion stimulation (DRG-S), an emerging therapy for complex regional pain syndrome (CRPS), post-surgical pain, and radiculopathy. DRG-S electrodes are placed percutaneously in the foraminal epidural space adjacent to the target DRG. The DRG is also the site of varicella-zoster virus latency, and its reactivation produces dermatomal herpes zoster (shingles) and post-herpetic neuralgia. Foraminal stenosis compressing the DRG in the lateral recess contributes to radicular pain independent of nerve root compression.
Dorsal root ganglion stimulation at the L4-L5 level for CRPS of the foot delivers precise neuromodulation to the painful extremity via an electrode placed percutaneously in the intervertebral foramen adjacent to the DRG; targeted stimulation of the foot area DRG produces paraesthesia coverage of the painful territory without stimulation of the back or non-painful areas.
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