Comparison and Multivariate Analysis of Radiofrequency and Pulsed Radiofrequency in the Treatment of Postherpetic Neuralgia

Abstract

Background: Postherpetic neuralgia(PHN) is the most common complication following herpes zoster. It presents as a persistent or paroxysmal stabbing or burning pain, usually beginning≥3 months after complete healing of the skin lesions. Radiofrequency(RF) and pulsed radiofrequency(PRF), as two minimally invasive interventional techniques, have been clinically validated in the treatment of PHN with good results. However, a comparative effect between the two has not been reported so far. The aim of this cohort study to Compare and multivariate analysis of RF and PRF in the treatment of PHN. Methods: A total of 164 PHN patients who received RF or PRF from January 2020 to October 2021 were retrospectively analyzed. There were 68 cases in PRF group and 96 cases in RF group. The pain (visual analogue scale, VAS), quality of life (36-Item Short Form Health Survey, SF-36), sleep quality (Athens insomnia scale, AIS) and postoperative complications were evaluated and compared before and after surgery at 1W, 1M, 3M,6M and 12M. The factors that may affect the treatment effect were also analyzed. Result: The VAS and SF-36 after surgery at 1W, 1M, 3M, 6M and 12M in PRF group and RF group were significantly improved compared with those before operation (P<0.01). VAS decreased more in PRF group than in RF group at 6M after operation (P<0.05).The improvement of mental health SF-36 after surgery at 1W, 3M, 6M and 12M in PRF group was better than that in RF group (P<0.05). The physical functioning of SF-36 in PRF group was significantly higher than that in RF group at 1W, 1M, 3M, 6M and 12M after operation(P<0.01). Social functioning of SF-36 in PRF group increased more after surgery at 3M, 6M and 12M, which was better than that in RF group (P<0.05). In terms of sleep quality, postoperative PRF group and RF group were significantly improved compared with preoperative ones (P<0.01), but there was no significant difference between the two groups. Logistic regression analysis showed that age, gender, preoperative VAS and complications were the possible factors affecting the postoperative outcome. Conclusion：Both RF and PRF have significant therapeutic effects on PHN. PRF has greater advantages than RF in reducing postoperative pain and improving quality of life. Age, gender, preoperative pain and complications are the possible related factors affecting the efficacy of RF and PRF therapy for PHN.