PDF(Pubmed)
Abstract：
Introduction: Preventing the development of postherpetic neuralgia (PHN), the most prevalent and severe complication of herpes zoster (HZ), is vital. Recently, it has been suggested that using temporary spinal cord stimulation (tSCS) for 10-14 days can improve HZ-associated pain (ZAP) and prevent PHN. However, myelitis complicates HZ. Permanent SCS has been successful in treating neuropathic pain induced by postoperative transverse myelitis of the spine that has not responded to traditional multidisciplinary treatment. However, it is unknown whether tSCS can reduce ZAP complicated with myelitis. Methodology: Between January 2020 and April 2022, all patients with HZ who visited our pain clinic with spinal cord edema and who underwent tSCS were enrolled in this study; their medical records were retrospectively examined. Pain intensity was assessed at baseline (before initiating interventional procedures), just before tSCS, after tSCS removal, and one and three months after tSCS. Results: Twelve patients were enrolled. The mean Numerical Rating Scale (NRS) was 7.9 ± 1.6 at baseline (before interventional procedures), 6.8 ± 2.2 before tSCS (after interventional procedures), and 3.5 ± 2.4 after tSCS. Compared with before tSCS, the mean NRS decreased to 3.3 ± 2.3 after tSCS (P = 0.0004). The mean NRS changes with interventional procedures before and after tSCS were -1.2 ± 2.2 (P = 0.0945) and 3.3 ± 2.3 (P = 0.0004), respectively; the change after tSCS was significantly higher (between-group difference: -2.1 ± 3.7; P = 0.0324). Conclusions: Temporary SCS alleviated pain in cases of shingles with myelitis refractory to interventional therapy. Even in cases with myelitis, tSCS for ZAP remains an effective way to prevent PHN.
摘要：
简介：预防带状疱疹后遗神经痛（PHN）的发展，带状疱疹最常见和最严重的并发症（HZ），是至关重要的。最近,有人建议使用10-14天的临时脊髓刺激（tSCS）可以改善HZ相关疼痛（ZAP）并预防PHN。然而,脊髓炎使HZ复杂化。永久性SCS已成功治疗由脊柱术后横贯性脊髓炎引起的神经性疼痛，而传统的多学科治疗没有反应。然而,目前尚不清楚tSCS是否能降低ZAP并发脊髓炎。方法：在2020年1月至2022年4月之间，所有因脊髓水肿就诊于我们疼痛诊所并接受tSCS的HZ患者均纳入本研究；他们的医疗记录进行了回顾性检查。在基线时（在开始介入手术之前）评估疼痛强度，就在tSCS之前，tSCS移除后，TSCS后一两个月。结果：共纳入12例患者。基线时（介入手术前）的平均数值评定量表（NRS）为7.9±1.6，tSCS前6.8±2.2（介入手术后），tSCS后3.5±2.4。与tSCS之前相比，tSCS后平均NRS降至3.3±2.3(P=0.0004)。介入手术前后的平均NRS变化分别为-1.2±2.2(P=0.0945)和3.3±2.3(P=0.0004)。分别；tSCS后的变化显着升高（组间差异：-2.1±3.7；P=0.0324）。结论：暂时性SCS减轻了对介入治疗难治性脊髓炎的带状疱疹患者的疼痛。即使在脊髓炎的病例中，用于ZAP的tSCS仍然是预防PHN的有效方法。
