Analysis Of The Efficacy Of Early Application Of Spinal Cord Stimulation In The Treatment Of Zoster-Associated Pain

Objective:This study was conducted to compare the efficacy of spinal cord stimulation(SCS)and gabapentin as the preferred treatment options for zoster-associated pain(ZAP),respectively.Methods:Retrospective analysis of 60 patients diagnosed with herpes zoster neuralgia from September 2018 to January 2022 in the pain department of Baiqiuen Hospital,Shanxi Province.Patients were divided into group A and group B according to their treatment choice at the time of consultation,with 30 patients in each group.All enrolled patients underwent infrared thermography at the initial visit.Patients in both groups were treated with basic therapy immediately after consultation:Oral vaxilovir,0.3 g twice daily,and mecobalamin,0.5 mg three times daily.Group A patients were treated with spinal cord stimulation after completion of admission-related tests,group B patients were treated with standardized drug therapy,this means that the starting dose of gabapentin is 300 mg per day and is increased gradually according to the degree of pain,up to a maximum dose of1800 mg per day.The patients’ VAS scores,Mc Gill scores,and sleep quality were recorded preoperatively,at 7 days,14 days,28 days,and 3 months postoperatively at each time point,respectively.The difference in skin temperature ΔT between the affected side and the healthy side in the skin infrared thermogram was recorded at each time point before surgery,14 days and 28 days after surgery,and the incidence of postherpetic neuralgia(PHN)at 28 days and 3 months after surgery,and the data were statistically analyzed.Results:Comparison of VAS scores,Mc Gill scores,and Δ T values of skin infrared thermography between the two groups,with no statistically significant preoperative differences.At each postoperative follow-up time point,both groups showed a significant decrease compared with the preoperative period(P<0.05),and both groups A were significantly lower than group B(P<0.001).The number of patients in both groups whose sleep quality was affected at the postoperative follow-up time point was reduced in both groups compared with the preoperative period(P<0.05),and the number of patients affected in group A was significantly less than that in group B(P<0.001).And at 3months postoperatively,the number of affected individuals was further reduced in group A compared to 28 days postoperatively(P<0.05),but increased in group B(P<0.05).The incidence of PHN was significantly lower(P<0.05)in group A(6.7%)than in group B(30%)at 1 month postoperatively,and was further reduced in group A(3.3%)and increased in group B(33.3%)at 3 months postoperatively,and was significantly lower(P<0.05)in group A than in group B.Conclusion:1.For the treatment of neuralgia in the acute phase of herpes zoster,both treatments are effective.2.The efficacy of spinal cord stimulation treatment is better than gabapentin treatment.More stable efficacy of spinal cord stimulation,with sustained and long-lasting analgesia;3.Spinal cord stimulation may be used as a stand-alone and preferred treatment rather than as a further therapeutic measure after pharmacological treatment has failed;4.The shorter the duration of the disease,the better the effect of spinal cord stimulation treatment.5.Spinal cord stimulation therapy is somewhat more effective in reducing the incidence of PHN than oral drug therapy.