The Effect of CT-Guided Pulsed Radiofrequency Combined with Ozone Injection on Zoster-Associated Pain: A Retrospective Study

Abstract

Purpose Globally, the incidence of herpes zoster (HZ) is increasing, and the resulting zoster-associated pain (ZAP) severely affects the quality of life of patients. Therefore, active treatment of ZAP and prevention of postherpetic neuralgia (PHN) are very important for patients in the early stage of the disease. This retrospective observational study aimed to evaluate the effect of CT-guided pulsed radiofrequency (PRF) combined with ozone injection on zoster-associated pain. Patients and Methods From 2018 to 2020, 84 patients with AHN (n=28), SHN (n=32), or PHN (n=24) underwent PRF combined with ozone injection treatment after pharmacologic and conservative therapies failed. The visual analogue scale (VAS), the Pittsburgh Sleep Quality Index (PSQI), and pregabalin consumption were recorded at baseline, post-PRF, and at 1, 3, 6, and 12 months after treatment. The number of remediations performed and adverse reactions were recorded, and treatment inefficiency was calculated using a VAS score greater than 3 as the criterion. Results The pooled results demonstrated statistically significant decreases in VAS scores, PSQI scores and consumption of pregabalin post-PRF and at 1, 3, 6, and 12 months follow-up (P<0.05). Compared with the PHN group, both the AHN and SHN groups showed clinical and statistical improvement in VAS scores and PSQI scores and in consumption of pregabalin (P< 0.05). At 1 year after the operation, the PHN group had a significantly greater number of remediation events and greater treatment inefficiency than the other two groups. No serious adverse events were observed during the procedure or during the follow-up period. Conclusion CT-guided PRF combined with ozone injection is safe and effective for individuals with ZAP, and its short-term and long-term effects are significant. In a sense, early PRF combined with ozone injection is more effective.

A bibliometric and visualization analysis of global research on postherpetic neuralgia from 2000 to 2022: A review

“…[ 53 ] Specifically, it has been increasingly utilized for the relief of PHN in recent years, demonstrating both safety and efficacy. [ 54 ] For “prevention,” the prevention of PHN has been a prominent area of research in recent years, with a focus on interventions such as vaccination, [ 55 ] gabapentinoids, [ 56 ] epidural block. [ 57 ] For “herpes zoster,” the occurrence of PHN is causally associated with HZ.…”

CT-guided Dorsal Root Ganglion Ozone Injection Combined With Pulsed Radiofrequency for Acute Herpes Zoster Neuralgia Treatment of Middle-aged and Elderly People

“…A previous study reported that ozone therapy has almost no side effects and is safe for clinical application 15 . Presently, it has been reported that ozone therapy can relieve HZ-associated neuralgia 16,17 . However, previous studies were retrospective and conducted on a small sample size.…”

“… 15 Presently, it has been reported that ozone therapy can relieve HZ-associated neuralgia. 16 , 17 However, previous studies were retrospective and conducted on a small sample size. Therefore, in the present study, we focused on the clinical efficacy of dorsal root ganglion (DRG) ozone injection combined with pulsed radiofrequency for treating acute HZ neuralgia in middle-aged and elderly adults, as well as explored its preventive effect on the occurrence of PHN.…”