Overview
Dorsal root ganglion (DRG) stimulation is an advanced neuromodulation therapy that delivers electrical stimulation directly to the dorsal root ganglion — a cluster of sensory nerve cell bodies located at each spinal level where nerve roots exit the spine. The DRG acts as a gatekeeper for sensory information traveling from the body to the spinal cord, making it an ideal target for modulating pain in specific, well-defined anatomical distributions. DRG stimulation is FDA-approved for complex regional pain syndrome (CRPS) of the lower extremities and has emerging evidence for post-surgical neuropathic pain, foot and ankle pain, and other focal pain conditions. Dr. Migdale has published research on DRG stimulation for CRPS with atypical findings, presented at the NANS 2026 Annual Meeting.
Why DRG Stimulation Differs from SCS
Traditional spinal cord stimulation targets the dorsal columns of the spinal cord broadly. DRG stimulation targets a specific ganglion at a specific spinal level — providing highly focal stimulation that matches the exact anatomical distribution of the patient's pain. This precision is particularly valuable for pain in the foot, knee, groin, or chest wall — distributions that can be difficult to cover adequately with conventional SCS leads.
The Procedure
DRG stimulation trial and implantation follow a similar process to SCS: a trial period with externalized leads, followed by permanent implantation if the trial is successful. The leads are placed in the epidural space and steered into the foraminal region adjacent to the target DRG under fluoroscopic guidance. The procedure requires specialized training; Dr. Migdale completed fellowship training in DRG stimulation at Dartmouth-Hitchcock Medical Center.
Research: Dr. Migdale's NANS Abstract
Dr. Migdale co-authored an accepted abstract at the North American Neuromodulation Society (NANS) 2026 Annual Meeting on 'Dorsal Root Ganglion Stimulation for Complex Regional Pain Syndrome with Atypical Findings on Triple-Phase Bone Scan: A Case Report.' This work highlights the potential of DRG stimulation in challenging CRPS presentations where typical diagnostic findings are absent, expanding the evidence base for this technology.