Efficacy and safety of pulsed radiofrequency modulation of thoracic dorsal root ganglion or intercostal nerve on postherpetic neuralgia in aged patients: a retrospective study

Abstract

Background Postherpetic neuralgia (PHN) is common in elderly patients and can be alleviated by pulsed radiofrequency (PRF). However, PRF treatments display different efficacy on different nerves. The purpose of this study was to evaluate the efficacy and safety of ultrasound-guided PRF modulation on thoracic dorsal root ganglion (DRG) or intercostal nerve (ICN) for PHN in aged patients and to provide a theoretical basis for clinical treatment. Methods We classified aged patients into two groups, DRG group and ICN group, based on the needle tip position. Visual analogue scale (VAS) and concise health status questionnaire (Short-form 36 health/survey questionnaire, SF-36) were used to evaluate the pain intensity and the life quality of the patients before and 2, 4 and 12 weeks after the PRF treatments. We also recorded the adverse reactions during the treatments. Results After the PRF treatment, the scores of VAS and SF-36 (assessing general health perception, social function, emotional role, mental health, and pain) improved significantly in both groups (P < 0.05). The mean VAS score in the DRG group was significantly lower than that in the ICN group 2 weeks after treatment, and remained for 12 weeks. The SF-36 scores in the DRG group were significantly higher than those in the ICN group (P < 0.05). We found a similar incidence of adverse reactions between the two groups (P > 0.05). Conclusions PRF therapy is safe and effective for elderly patients with postherpetic neuralgia. However, PRF treatment in dorsal root ganglion is superior to that in intercostal nerve with improving VAS and SF-36 scores to a greater extent in older patients. Trial registration ChiCTR2100044176.

Pulsed Radiofrequency Combined With Methylene Blue Paravertebral Nerve Block Effectively Treats Thoracic Postherpetic Neuralgia

“…This allows PRF to ease PHN without changing the nerve fiber structure (23,24). In this study, pain was relieved after PRF therapy, which is consistent with the findings of previous studies (10)(11)(12)(13). However, other studies reported that PRF therapy efficacy in treating PHN was not ideal (14,15).…”

“…However, there are different opinions about the effectiveness of PRF therapy for PHN. Some reports believe that PRF can effectively relieve pain and improve the quality of life of patients with PHN (10)(11)(12)(13). Other reports suggest that PRF is not the ideal therapy for treating neuropathic pain (14) and that PRF does not significantly relieve nerve root pain (15).…”

Persistent idiopathic facial pain treated with botulinum toxin and pulsed radiofrequency of infraorbital nerve: a case report

“…Botulinum toxin has been used successfully in various orofacial pain conditions, such as trigeminal neuralgia [ 11 ], nonodontogenic facial pain, including atypical facial pain [ 12 ], and atypical odontalgia [ 13 ]. The exact mechanism of PRF treatment is unknown, but it is believed to act by neuromodulation and changes in the neuronal structure without causing significant structural damage [ 14 ]. PRF has been used successfully in various orofacial pain conditions, such as trigeminal neuralgia and glossopharyngeal neuralgia.…”

Research Trends and Hotspots on Herpes Zoster: A 10-Year Bibliometric Analysis (2012–2021)

“…Herpes zoster infection usually manifests as a blistered, painful skin rash with several complications, causing a considerable burden to patients, society, and the country ( 6 , 7 ). The most common and difficult to tolerate symptom is postherpetic neuralgia, which can cause severe chronic pain and limitations in activities ( 8 – 10 ).…”

“…For drug-refractory cases, interventional, physical, and psychological therapies are available ( 6 , 11 ). Pulsed radiofrequency therapy has gained popularity in recent years ( 7 ). Because eradication of the virus itself is difficult, prevention of infection is an attractive route for researchers.…”