| Objective: To analyze and compare the comprehensive therapeutic effect of temporary spinal cord stimulation and pulsed radiofrequency treatment for herpes zoster associated neuralgia at different stages,and to explore the possible factors affecting the efficacy of these patients and the risk factors of postherpetic neuralgia.Methods: 76 patients with herpes zoster associated neuralgia were selected and divided into pulsed radiofrequency group(PRF group,47 cases)and temporary spinal cord stimulation group(SCS group,29 cases)according to different treatment methods.Visual Analogue Scale(VAS)was applied to evaluate the degree of pain in patients,and the Brief Pain Inventory(BPI)was used to assess quality of life.Preoperative and postoperative doses of tramadol and gabapentin as well as the incidence of postherpetic neuralgia and the number of patients who could stop analgesic drugs 12 weeks after surgery in two groups were recorded,.The levels of Tlymphocyte subsets,preoperative serum tumor necrosis factor α(TNF-α)and Interleukin-6(IL-6)were compared between two groups.The correlations between TNF-α or IL-6 and VAS scores were analyzed,and the treatment effects in different ages,disease durations,nerve segments and preoperative VAS scores were observed,and the correlation between these factors and efficacy was analyzed.Results:1.The VAS scores at each time point in the two groups were lower than before the operation,and the difference was statistically significant(P < 0.05).The degree of improvement in quality of life and pain relief was significantly better than that in the PRF group at each time after surgery(P < 0.05).2.The doses of tramadol and gabapentin in the two groups were decreased after surgery in two groups.The doses of tramadol in SCS group were significantly less than the PRF group at the 4th,8th,and 12 th week after operation(P < 0.05),and the doses of gabapentin in SCS group were significantly less than the PRF group(P <0.05).3.The incidence of postherpetic neuralgia was not significantly different(P >0.05).There were 17 patients(58.6%)in the SCS group and 18 patients(38.3%)in the PRF group stopped analgesic drugs 12 weeks after surgery.The difference in two groups was statistically significant(P < 0.05).4.The level of serum TNF-α in patients with PHN was not significantly different from those without PHN after operation(P > 0.05).The level of serum IL-6 in the former was significantly higher than those in the latter(P < 0.05)),the level of serum IL-6 and VAS scores were correlated(P <0.05,r = 0.886).There was no significance difference between the number of T-lymphocyte subsets and the normal value in two group.5.Different ages,nerve segments and different preoperative VAS scores had no significant effect on the efficacy of the two groups(P> 0.05);The course of the disease is an important factor affecting the efficacy of the two groups of patients;Compared with the control group,the SCS group had a better effect on patients with a course of more than 3 months than the PRF group(P < 0.05).Conclusion:1.Temporary Spinal cord stimulation and pulsed radiofrequency are effective methods for the treatment of herpes zoster associated neuralgia.The former’s comprehensive effect is better than the latter.2.Elevated serum IL-6 level may be an important predictor of PHN,and may also be one of the factors that affect the efficacy.3.The course of disease is an important factor affecting efficacy,As early as possible interventional therapy seems to improve the efficacy,but the patient’s age,the distribution of diseased nerve segments and preoperative VAS scores have no significant effect on efficacy. |
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