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A dorsal root ganglion (or spinal ganglion; also known as a posterior root ganglion [1]) is a cluster of neurons (a ganglion) in a dorsal root of a spinal nerve. The cell bodies of sensory neurons known as first-order neurons are located in the dorsal root ganglia. [2] The axons of dorsal root ganglion neurons are known as afferents.
Dorsal root ganglion stimulation is a type of neurostimulation that is effective in the management of focal neuropathic pain. The FDA approved its use in February 2016. The ACCURATE Study demonstrated superiority of dorsal root ganglion stimulation over spinal (dorsal column) stimulation in the management of CRPS and causalgia. [62]
Sodium voltage-gated channel alpha subunit 9 (also Na v 1.7) is a sodium ion channel that, in humans, is encoded by the SCN9A gene. [5] [6] [7] It is usually expressed at high levels in two types of neurons: the nociceptive (pain) neurons at the dorsal root ganglion (DRG) and trigeminal ganglion; and sympathetic ganglion neurons, which are part of the autonomic (involuntary) nervous system.
WDR neurons are a huge part of the somatosensory system, helping to send and receive signals based on sensory changes in the body. The TRPA1 channel has been closely associated with temperature and pain sensation in primary afferent sensory neurons and are largely found in nociceptive sensory neurons in the dorsal root ganglia. [14]
The dorsal root ganglion contains cell bodies for sensory nerves including large, myelinated Aβ fibers which carry proprioception and tactile touch sensation to the brain via the dorsal column–medial lemniscus pathway and small, unmyelinated C fibers which carry thermal and pain sensation to the brain via the spinothalamic tract. [2]
The root emerges from the posterior part of the spinal cord and travels to the dorsal root ganglion. The dorsal root ganglia contain the pseudo-unipolar cell bodies of the nerve fibres which travel from the ganglia through the root into the spinal cord. The lateral division of the dorsal root contains lightly myelinated and unmyelinated fibres ...
Stimulation is typically in the 20–200 Hz range, though a novel class of stimulation parameters are now emerging that employ a 10 kHz stimulation train as well as 500 Hz "burst stimulation". Kilohertz stimulation trains have been applied to both the spinal cord proper as well as the dorsal root ganglion in humans.
A newer form of spinal cord stimulation called dorsal root ganglion stimulation (DRG) has shown a great deal of promise for treating pelvic pain due to its ability to affect multiple parts of the nervous system simultaneously – it is particularly effective in patients with "known cause" (i.e. post surgical pain, endometriosis, pudendal ...
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