Clinical Observation Of Ultrasound-guided Intervertebral Foramen And Interlaminar Epidural Block In The Treatment Of Acute Herpes Zoster

Objective: To compare the short-term clinical efficacy and complications of ultrasound-guided Transforaminal Epidural Steroid Injection(TFESI)and Interlaminar Epidural Steroid Injection(ILESI)in the treatment of acute herpes zoster.Methods: This study was a randomized controlled trial.A total of 60 eligible patients with acute shingles who were enrolled into the inpatient department of the pain department of The First Affiliated Hospital of Nanchang University from January 2017 to December 2018 and whose VAS score was still greater than 5 after 1week of treatment with antiviral,oral pregabalin and tramadol were randomly divided into two groups,30 patients in each group.The TF group was treated with ultrasound-guided epidural steroid injection,and the IL group was treated with ultrasound-guided epidural steroid injection.Short-form of Mc Gill pain questionnaire(SF-MPQ),visual analogue scale(VAS)and Sleep Interference Score(SIS)were used to compare the clinical effects of two groups of patients before treatment,1 week,2 weeks and 4 weeks after treatment,and the complications of the two treatment methods were compared.Results: There was no statistical difference in the general condition between the two groups before treatment.Compared with before treatment,the VAS score,SF-MPQ and SIS scores of the two groups were significantly lower than those before treatment(P<0.05).The SF-MPQ,VAS,and SIS scores in the IL group were higher than those in the TF group at 1 week,2 weeks,and 4 weeks after treatment,and the difference was statistically significant(P<0.05).Except for one patient in the TF group,the needle was mistakenly inserted into the blood vessel.Except for 1 patient in TF group whose puncture needle strayed into the blood vessel,no severe complications such as epidural hematoma and spinal canal infection occurred in both groups.Conclusion: Both TFESI and ILESI under ultrasound guidance can effectively alleviate the pain symptoms of patients with acute herpes zoster,improve sleep and improve the quality of life,but the clinical effect of TF group is better than that of theIL group,and the safety of the IL group may be higher.