Spinal cord stimulation and pulsed radiofrequency in treatment of herpes zoster neuralgia in the elderly

Objective To investigate the efficacies and differences of spinal cord stimulation (SCS) and pulsed radiofrequency (PRF) in the treatment of herpes zoster neuralgia in the elderly. Methods Sixty-three patients with herpes zoster neuralgia over 50 years old, admitted to our hospital from January 2018 to January 2019, were divided into SCS group (n=31) and PRF group (n=32) by prospective, randomized and controlled study. The stimulating electrodes were placed in epidural spinal ganglion segment for two weeks after percutaneous puncture in SCS group. In the PRF group, the radiofrequency needles were percutaneously punctured to the dorsal root ganglion under the guidance of X-ray. After the location of contrast medium was confirmed, each target was treated by pulsed radiofrequency for 360 seconds, followed by anti-inflammatory compound liquid injection. Numeric Rating Scale (NRS) scores, effective rate (percentage of patients having pain relief>50%) and complete relief rate (percentage of patients having NRS scores≤3) before, and one, 4, 12 and 24 weeks after operation of the patients from the two groups were recorded. Use of analgesics and calcium channel antagonists of the patients from the two groups were compared. Results NRS scores of patients from the two groups after operation were significantly lower than those before operation (P 0.05). The effective rates of pain treatment of patients from the two group reached to 56.67%-81.25%, and there was no significant difference between the two groups at each time point (P>0.05). The complete pain relief rate reached to 37%-71% in the two groups, and there was no significant difference between the two groups at each time point (P>0.05). Number of patients used analgesics and calcium channel antagonists before and after operation in the two groups showed significant differences (χ2=20.917, P=0.000; χ2=18.273, P=0.000), and number of patients used analgesics and calcium channel antagonists 4, 12 and 24 weeks after operation in the two groups was significantly smaller than that before operation (P 0.05). Conclusion SCS and PFR can effectively treat herpes zoster neuralgia and reduce the incidence of sequelae, without no significant difference in the clinical efficacy. Key words: Herpes zoster neuralgia; Spinal cord stimulation; Pulsed radiofrequency