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INTRODUCTION Disruptions of lumbar intervertebral discs may lead to severe discogenic low back pain (LBP). Severe pain has a deleterious effect on physical function and quality of life. Spinal cord stimulation (SCS) is a robust treatment for many neuropathic pain conditions. New innovations may be well-suited to treat neuropathic chronic LBP, including discogenic pain. The aim of this prospective study was to determine the effect of dorsal root ganglion (DRG) stimulation for a well-selected group of patients with discogenic LBP with no history of previous back surgeries. METHODS Twenty subjects with confirmed discogenic LBP and no prior history of back surgery underwent trials of DRG stimulation and, if successful with at least 50% pain reduction, were permanently implanted. Subjects rated their pain, disability, quality of life, and mood at baseline, and 14 subjects were followed through 12 months of treatment. RESULTS Treatment with DRG stimulation reduced LBP ratings (68.3% reduction), from mean 7.20 ± 1.3 at baseline to 2.29 ± 2.1 after 12 months (p = < 0.001). Oswestry ratings of disability significantly decreased (p = < 0.001) from 42.09 ± 12.9 at baseline to 21.54 ± 16.4 after six months of treatment and to 20.1 ± 16.6 after 12 months. The average quality of life EQ-5D index score at baseline was 0.61 ± 0.12 and 0.84 ± 0.13 after 12 months. DISCUSSION DRG stimulation treatment for discogenic LBP improved the level of pain, function, and quality of life. Further research is necessary into efficacy of DRG stimulation in patients with chronic discogenic LBP and to determine the place of SCS in the treatment algorithm.

Introduction High-frequency spinal cord stimulation (HF SCS) is a relatively new modality of SCS. The present general advice concerning pregnancy and SCS, in general, is to turn the device off because of insufficient knowledge concerning the impact on the developing fetus. As HF stimulation generates higher energies, potential adverse fetal effects could be theoretically stronger. Case This case report describes a 36-year-old woman who had two pregnancies with an active HF SCS system. Her first pregnancy ended in a miscarriage. During her second pregnancy, she continued stimulation treatment during the whole pregnancy. She gave birth to a healthy baby. Conclusions This case describes both a miscarriage and the birth of a healthy baby in a patient treated with HF SCS. It is not possible to rule out that the HF SCS could have caused the miscarriage. Also, the birth of the healthy baby after the second pregnancy in which HF SCS was used the whole period, is not a valid reason to declare HF SCS and SCS, in general, safe during pregnancy. As no sufficient data are available, we must remain cautious about any unknown possible adverse effects or delayed adverse events because of SCS and maybe especially HF stimulation. All outcome data on pregnancies during all types of SCS ideally should be collected and analyzed.