Close-up photo of a spinal x-rayAt Alliance Spine and Pain Centers, we’re leading the way to the future of pain relief with innovative, individualized, evidence-based treatments.

Learn more about emerging technology in pain management at Alliance Spine and Pain Centers.

Doctor examining knee of patient

What Is Dorsal Root Ganglion Stimulation?

Finding innovative solutions for stubborn chronic pain is at the forefront of what we do here at Alliance Spine and Pain Centers. One cutting-edge option offered by our doctors is dorsal root ganglion (DRG) stimulation.

Used to alleviate persistent pain in lower regions of the body, this groundbreaking treatment can deliver life-changing results for certain patient populations. Here’s a closer look at what the treatment involves.

What Does the DRG Stimulation Procedure Entail?

DRG stimulation is a form of neuromodulation, a technique that alters nerve activity to alleviate pain. This particular procedure focuses on the dorsal root ganglia (DRGs), a group of densely populated nerves that run along the spinal column, regulating pain signals via nerve fibers.

There are various DRGs positioned along the spine, each of which corresponds with different areas of the body. DRG stimulation therapy can pinpoint pain in these specific areas. Common pain sites targeted by the treatment are the groin, hip, knee, or foot.

There are several components of DRG stimulation therapy, including:

  • The generator, a small, battery-operated device which is implanted in the body and sends out electrical pulses
  • Thin wires which are placed near the affected DRG to deliver electrical pulses from the generator
  • A controller which allows the patient to adjust the level of stimulation or turn it on and off as needed

The Proclaim™ DRG Neurostimulator System which our doctors provide even allows patients to cycle through various programs and upgrade technology as it improves by receiving software updates. This means patients can continue to benefit from advancements without the need for further procedures.

To assess whether DRG stimulation therapy will be effective, the implantation of the device may start with a trial placement. In this process, leads for the trial stimulator will be temporarily implanted through the skin via needle insertion into the epidural space. If after several days the trial proves to be successful, a permanent stimulator can be implanted via two small incisions. The procedure is typically performed on an outpatient basis under conscious sedation and takes roughly 30 to 40 minutes to complete.

Who Is a Good Candidate?

Chronic pain can be particularly difficult to treat in certain areas of the body. Regions such as the foot, knee, groin, or hip can experience lingering pain following an injury or surgical procedure. When suffering doesn’t subside after other therapies have been tried, patients may become good candidates for DRG stimulation.

Specifically, patients who have the following symptoms may be most likely to benefit from the treatment:

  • Pain that has lasted at least six months
  • Pain that’s isolated to a specific region, such as the knee, hip, groin, or foot
  • Pain that hasn’t responded well from previous pain management techniques, which may include nerve blocks, traditional neurostimulation, or even surgery

DRG stimulation is a cutting-edge procedure, and there are still relatively few pain management specialists who offer the treatment. Alliance Spine and Pain Centers doesn’t just offer this technique; we have multiple doctors who specialize in it.

If you think you could benefit from DRG stimulation or any of the other pain relief therapies we offer, contact our office online to schedule a consultation, or call 770-929-9033.


illustrations of a human spinal cord

How Does Spinal Cord Stimulation Work?

Spinal Cord Stimulation (SCS) is a procedure you may have heard of if you have chronic pain. This process involves surgically inserting a device under your skin to send electrical signals to the brain, blocking pain responses.

Looking into SCS can provide hope, but it can also feel daunting. That’s why we’re here to break down the ins and outs of what you need to know.

What Causes Chronic Back Pain?

To understand how SCS helps chronic pain, it’s important to understand what first causes it. Glial cells are key contributors, as they send pain signals to the brain through the spinal cord. They can also contribute to pro-inflammatory responses, and inflame chronic pain sites.

These glial cell signals can be manipulated, however, with an SCS procedure.

How does Spinal Cord Stimulation Help?

An SCS system targets glial cells, modifying their pain signals to the brain. The procedure involves connecting a small device to thin wire leads that are implanted into a specific area in your back, continuously sending electrical pulses to the correct glial cells.

Even if it does not remove a pain’s source, research shows that 92.4% of patients who received SCS were satisfied with the results. While each patient experiences unique pain (and therefore a unique relief), SCS is considered successful when your pain is reduced at least by 50%.

How Patients Get Started

If you qualify for SCS, you will first undergo a trial procedure. During this phase, at least one insulated wire lead is placed through an epidural needle into your spinal canal. The needles are removed, leaving the wires in place and the wires are attached to an external battery — called a trial stimulator.

Once the leads and trial stimulator are connected, you and your physician will monitor your pain levels for about seven days. After this trial period, the lead is removed. If the relief is deemed sufficient, you may move forward with the permanent procedure.

The Permanent Procedure

The permanent procedure is not as daunting as it may sound. You can expect to go home the same day once these three steps are complete:

  1. Permanent leads are inserted into your spine. This is done with an epidural needle through a small incision.
  2. Another small incision is then made to insert the implantable pulse generator (IPG) beneath the skin, usually on the buttocks or abdomen. The leads are then connected to the IPG battery.
  3. Finally, a wireless electrical control unit programs the IPG’s electrical pulses. This way, you can turn the system on or off using the external control unit, or change its stimulation power.

After the Procedure

You may experience discomfort and swelling around the incision site for a few days. Once the incision has healed, you will be able to continue your daily activities, with less pain and discomfort.

Potential Risk

A 2011 retrospective review of SCS reported that hardware complications were the most common defaults in SCS procedures. Some patients (22.6%) experienced lead migration, where the wires shifted after time. Others (12%) experienced pain at the generator site.

Overall, SCS procedures are very safe, with few complications, and deaths or neurological deficits only rarely reported.

Who is Spinal Cord Stimulation Good For?

You may be a candidate for SCS if you have pain resulting from previous back or neck surgery,  diabetic neuropathy, or other chronic back, lower body, and arm pain.

Deciding the Best Spinal Cord Stimulator Device to Use

With the rapidly technology improvements for spinal cord stimulation, Alliance works closely with the top medical device companies as they advance their SCS systems. This industry’s innovative interventional pain management systems continuously improve to offer more benefits to a wider range of people needing this treatment.

Alliance physicians determine the type of SCS system for their patients based the patient’s type of pain and its source. Here are a few examples of the wide range of SCS treatment options that Alliance offers:

  • The HFX Solution treatment, the only spinal cord stimulation system approved by the FDA that uses high frequency stimulation to manage pain associated with diabetic neuropathy, or other chronic pain.
  • Nalu Neuromodulation training, a new device that will allow our physicians to help target pain through Peripheral Nerve Stimulation and Spinal Cord Stimulation using a generator that is ultra-small.
  • Medtronic DTM™ (Differential Target Multiplexed), a Spinal Cord Stimulation waveform to help treat patients with chronic, intractable low back pain.
  • Evoke® Spinal Cord Stimulation (SCS) System, a new investigational device designed to measure and record your body’s response to stimulation and makes millions of automatic, real-time adjustments to maintain a consistent level of pain relief.

If you are considering SCS, connect with Alliance Spine & Pain Centers. We understand the challenge of finding chronic pain relief, and our experts will help you find the answers. To schedule an appointment, Give us a call at 770-929-9033 or visit us online.

Dr. Scott Masson and Vertiflex rep posting with the Superion Vertiflex treatment box.

Dr. Scott Masson Is Now Offering Superion Vertiflex Procedure

Alliance Spine and Pain Centers is excited to announce that Dr. Scott Masson now performs the Superion Vertiflex procedure as a treatment option for his patients. Superion Vertiflex is a minimally invasive front-line treatment option for stenosis patients that is essentially an indirect spinal decompression. It gives patients the opportunity to live a more functional life. Learn more about one of our patient’s experience and positive results from this treatment under the care of Alliance’s Dr. Rosenfeld.

With innovative interventional pain treatments, our best-in-class physicians are leading the way to the future of pain relief. We are excited Dr. Masson will extend this care to a greater volume of Atlanta area patients. If you have any questions about the Superion Vertiflex procedure, Alliance Spine and Pain is here to help.

Reach out to any of our pain care specialists to make an appointment or by giving us a call at 770-929-9033.

Three men standing in an operating room at Alliance Spine and Pain Centers

Dr. David Rosenfeld of Alliance Spine and Pain Centers Teaches Course in Groundbreaking DRG Procedure

Alliance Spine and Pain Centers remains at the forefront of pain management by demonstrating the latest in best practices. Dr. David Rosenfeld recently did just that while teaching a course in dorsal root ganglion (DRG) therapy at the Medical Education and Research Institute in Memphis, Tenn.

Two physicians performing a procedure on a cadaver

Dr. Preteesh Patel during the procedure

Teaching the class alongside Dr. Rosenfeld was noted Alabama-based physician Dr. Michael Cosgrove. The pair demonstrated the placement of the Proclaim™ DRG Neurostimulator System in the lumbar and sacral spine of a cadaver. 

Dorsal root ganglion (DRG) therapy is a non-opioid therapy designed to manage difficult-to-treat chronic pain in specific areas of the lower body, such as the foot, knee, or groin. Pain in those areas is sometimes related to a cluster of nerves called the dorsal root ganglia. The Proclaim™ DRG Neurostimulator System can provide proven therapy to aid in treatment of chronic pain in those areas.

A total of 12 physicians from around the country attended the course, including Dr. Preetesh Patel of Alliance Spine and Pain Centers. 

“Having the opportunity to share groundbreaking therapies and procedures with my colleagues is a true honor and privilege,” says Dr. Rosenfeld. “It’s part of Alliance Spine and Pain Centers’ commitment to both our patients and the field.”

X-ray of an Inspan Interspinous Fixation Device

Alliance Performs First Interspinous Fixation Device in the State

David J. Rosenfeld, MD

Dr. David J. Rosenfeld performed the first Inspan Interspinous Fixation Device in Georgia.

As the leaders of the future of pain relief, Alliance Spine and Pain Center is proud to offer groundbreaking pain management treatments. In March 2021, we continued to demonstrate our leadership in the interventional pain management field when Dr. David J. Rosenfeld implanted the first Inspan Interspinous Fixation Device​ in the state of Georgia. 

By treating the underlying problem causing pain, this new interspinous fixation technique is minimally invasive and can provide lasting relief. Inspan opens the spinal canal and the foramen to relieve nerve compression. Then, it decompresses and fixates the facet joints to immobilize them for the bony surfaces to fuse, providing additional nerve compression relief.

Alliance Spine and Pain Centers is excited to offer the Inspan procedures along with many other innovative, integrated, and evidence-based treatments. We are proud of Dr. David Rosenfeld’s efforts to help Alliance continue to offer advanced technology to help relieve our patients’ pain.

If you have any questions about the Inspan Procedure, Alliance Spine and Pain is here to help. Reach out to any of our pain care specialists by clicking here or by giving us a call at 770-929-9033.