BACKGROUND: Phantom limb pain (PLP) is a common and disabling complication after amputation that may persist despite treatment. Dorsal root ganglion (DRG)-targeted interventions may offer focused treatment for refractory PLP.

CASE REPORT: We report 2 patients with refractory PLP treated with distinct DRG-targeted interventions. A 38-year-old man with prior complex regional pain syndrome developed PLP after transfemoral amputation despite spinal cord stimulation. L5 DRG stimulation reduced pain from a baseline VAS score of 9–10/10 to 2–3/10 at the initial postimplant assessment. Approximately 80% pain relief was reported at the 15-day follow-up. A 25-year-old woman developed focal PLP after fifth-toe amputation. Endocanal pulsed radiofrequency at the L5 DRG was associated with complete pain relief at 4- and 8-week follow-up and cessation of analgesics.

CONCLUSIONS: DRG stimulation and endocanal pulsed radiofrequency may be options for selected patients with refractory PLP. Given the limited follow-up of 15 days in Case 1 and 8 weeks in Case 2, longer follow-up and controlled studies are needed to assess durability and patient selection.

KEYWORDS: Phantom limb pain; dorsal root ganglion; neuromodulation; dorsal root ganglion stimulation; pulsed radiofrequency