Efficacy of Long-Term Spinal Nerve Posterior Ramus Pulsed Radiofrequency in Treating Subacute Herpetic Neuralgia: A Prospective Randomized Controlled Trial

Qing Sun^1,†, Jie Yuan^2,3,†, Junlong Yang⁴, Jinfeng Zou^1,*

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¹ Department of Pain, Guizhou Provincial People's Hospital, 550002 Guiyang, Guizhou, China

² Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, 563000 Zunyi, Guizhou, China

³ Department of Pain, Affiliated Hospital of Zunyi Medical University, 563000 Zunyi, Guizhou, China

⁴ Department of Pain, The Affiliated Hospital of Guizhou Medical University, 550004 Guiyang, Guizhou, China

^*Correspondence: zoujinfeng0101@sina.com (Jinfeng Zou)
^†These authors contributed equally.

J. Integr. Neurosci. 2023, 22(2), 47; https://doi.org/10.31083/j.jin2202047

Submitted: 29 September 2022 | Revised: 8 November 2022 | Accepted: 10 November 2022 | Published: 28 February 2023

(This article belongs to the Special Issue Sense Disorders in Neuroinflammatory and Neurodegenerative Disease)

This is an open access article under the CC BY 4.0 license.

Abstract

Objective: This study aimed to observe the clinical efficacy of long-term spinal nerve posterior ramus pulsed radiofrequency (PRF) in treating subacute herpes zoster neuralgia (HZN). Methods: A total of 120 patients with subacute HZN in the thoracolumbar region and back were equally randomized to the conventional PRF group (P group, n = 60), with a pulse of 180 s, or to the long-term PRF group (LP group, n = 60), with a pulse of 600 s. The patients’ baseline characteristics, the incidence rate of postherpetic neuralgia (PHN), and the dose of analgesics were compared between the two groups. Results: Based on the pain-rating index (PRI), the PRI-sensory, PRI-affective, visual analogue scale, and present pain intensity scores in the two groups were lower at T ${}_{2}$ , T ${}_{3}$ , and T ${}_{4}$ time points than at the T ${}_{1}$ time point after treatment (p $<$ 0.05). After 2 months, the dose of analgesics was significantly lower in the LP group than in the P group (p $<$ 0.05), and the incidence of PHN was considerably lower. Conclusions: Long-term spinal nerve posterior ramus PRF is a more effective treatment strategy for subacute HZN than conventional PRF. It can effectively prevent the occurrence of PHN.

Keywords

long-term pulsed radiofrequency

postherpetic neuralgia

pulsed radiofrequency

subacute herpes zoster neuralgia

Funding

gzwkj2021-284/Guizhou Provincial Health Commission

202042940112211125/Basic Research Program of Guizhou Provincial Science and Technology Department

Figures

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Fig. 1.

Proportion of clinically significant PHN 2 months after PRF treatment in the two patient groups. Gray and black bars show the incident rate of PHN in the LP and P groups, respectively. *p $<$ 0.05 indicates the comparison with the pretreatment value.

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J. Integr. Neurosci. Print ISSN 0219-6352 Electronic ISSN 1757-448X