Evaluation of the Efficacy of Unipolar and Bipolar Spinal Dorsal Root Ganglion Radiofrequency Thermocoagulation in the Treatment of Postherpetic Neuralgia

Overview

Journal Korean J Pain

Date 2021 Dec 30

PMID 34966018

Citations 5

Authors

Jianjun Zhu

Ge Luo

Qiuli He

Ming Yao

Affiliations

Soon will be listed here.

Abstract

Background: Different views have been proposed on the radiofrequency treatment modes and parameters of radiofrequency thermocoagulation of the spinal dorsal root ganglion for the treatment of postherpetic neuralgia (PHN). It is urgent to identify a more effective therapy for patients with PHN.

Methods: Patients who underwent radiofrequency thermocoagulation therapy for PHN were retrospectively reviewed and were divided into a radiofrequency thermocoagulation (CRF) and double neddles radiofrequency thermocoagulation (DCRF). The pain scores (numerical rating scale, NRS) were evaluated at the following time points: before the operation, 1 day, 3 months, 6 months, 1 year, and 2 years after operation. The incidence of complications and the degree of pain relief were evaluated. The in vitro ovalbumin experiment was used to indicate the effects of radiofrequency thermocoagulation.

Results: Compared with the preoperative NRS scores, the postoperative NRS scores decreased significantly; the NRS scores of the DCRF group was lower than that of the CRF group at all time points from 6 months to 2 years following the operation. The total effective rate of the DCRF group was significantly higher than that of the CRF group at 2 years following the operation. The incidence of numbness in the DCRF group was higher than that noted in the CRF group. The ovalbumin experiments in vitro indicated that the effects of radiofrequency thermocoagulation were optimal when the distance between the two needles was 5 mm.

Conclusions: DCRF with a 5 mm spacing exhibits a longer duration and higher effective rate in the treatment of PHN and is worth promoting.

Citing Articles

The CT-Imaging Location of Lumbar 3 Sympathetic Radiofrequency Thermocoagulation for Sympathetic-Related Diseases Therapy.

Wang R, Gao Z, Ma L J Pain Res. 2024; 17:4011-4022.

PMID: 39619212 PMC: 11608000. DOI: 10.2147/JPR.S473078.

Comprehensive Comparison of Therapeutic Efficacy of Radiofrequency Thermocoagulation and Pulsed Radiofrequency in Treatment of Elderly Patients with Thoracic Postherpetic Neuralgia.

Wang S, Wang H, Wang H, Zhang D, Nie H Med Sci Monit. 2023; 29:e942108.

PMID: 38073138 PMC: 10725043. DOI: 10.12659/MSM.942108.

Progress in Radiofrequency Therapy for Zoster-Associated Pain About Parameters, Modes, Targets, and Combined Therapy: A Narrative Review.

Rui M, Ni H, Xie K, Xu L, Yao M Pain Ther. 2023; 13(1):23-32.

PMID: 37962817 PMC: 10796860. DOI: 10.1007/s40122-023-00561-7.

Top 100 Most-Cited Papers in Herpes Zoster from 2000 to 2022: A Bibliometric Study.

Gao N, Li M, Wang W, Wang L, Liu Z, Guo Y J Pain Res. 2023; 16:1779-1797.

PMID: 37273270 PMC: 10237222. DOI: 10.2147/JPR.S409616.

Current scenario and future applicability of antivirals against herpes zoster.

Kim S Korean J Pain. 2022; 36(1):4-10.

PMID: 36573010 PMC: 9812693. DOI: 10.3344/kjp.22391.

References

Usmani H, Dureja G, Andleeb R, Tauheed N, Asif N . Conventional Radiofrequency Thermocoagulation vs Pulsed Radiofrequency Neuromodulation of Ganglion Impar in Chronic Perineal Pain of Nononcological Origin. Pain Med. 2018; 19(12):2348-2356. DOI: 10.1093/pm/pnx244. View

Ding Y, Yao P, Li H, Han Z, Wang S, Hong T . CT-Guided Stellate Ganglion Pulsed Radiofrequency Stimulation for Facial and Upper Limb Postherpetic Neuralgia. Front Neurosci. 2019; 13:170. PMC: 6418026. DOI: 10.3389/fnins.2019.00170. View

Freer G, Pistello M . Varicella-zoster virus infection: natural history, clinical manifestations, immunity and current and future vaccination strategies. New Microbiol. 2018; 41(2):95-105. View

Gross G, Eisert L, Doerr H, Fickenscher H, Knuf M, Maier P . S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia. J Dtsch Dermatol Ges. 2020; 18(1):55-78. DOI: 10.1111/ddg.14013. View

Huang B, Xie K, Chen Y, Wu J, Yao M . Bipolar radiofrequency ablation of mandibular branch for refractory V3 trigeminal neuralgia. J Pain Res. 2019; 12:1465-1474. PMC: 6514122. DOI: 10.2147/JPR.S197967. View

Cunningham A, Levin M . Herpes Zoster Vaccines. J Infect Dis. 2018; 218(suppl_2):S127-S133. DOI: 10.1093/infdis/jiy382. View

Gulec E, Ozbek H, Pektas S, Isik G . Bipolar Versus Unipolar Intraarticular Pulsed Radiofrequency Thermocoagulation in Chronic Knee Pain Treatment: A Prospective Randomized Trial. Pain Physician. 2017; 20(3):197-206. View

Koshy E, Mengting L, Kumar H, Jianbo W . Epidemiology, treatment and prevention of herpes zoster: A comprehensive review. Indian J Dermatol Venereol Leprol. 2018; 84(3):251-262. DOI: 10.4103/ijdvl.IJDVL_1021_16. View

Kawai K, Yawn B . Risk Factors for Herpes Zoster: A Systematic Review and Meta-analysis. Mayo Clin Proc. 2017; 92(12):1806-1821. DOI: 10.1016/j.mayocp.2017.10.009. View

10.

Yao P, Hong T, Wang Z, Ma J, Zhu Y, Li H . Treatment of bilateral idiopathic trigeminal neuralgia by radiofrequency thermocoagulation at different temperatures. Medicine (Baltimore). 2016; 95(29):e4274. PMC: 5265779. DOI: 10.1097/MD.0000000000004274. View

11.

Kawai K, Yawn B, Wollan P, Harpaz R . Increasing Incidence of Herpes Zoster Over a 60-year Period From a Population-based Study. Clin Infect Dis. 2016; 63(2):221-6. PMC: 4928389. DOI: 10.1093/cid/ciw296. View

12.

Elawamy A, Abdalla E, Shehata G . Effects of Pulsed Versus Conventional Versus Combined Radiofrequency for the Treatment of Trigeminal Neuralgia: A Prospective Study. Pain Physician. 2017; 20(6):E873-E881. View

13.

Lin C, Lin Y, Lao H, Chen C . Interventional Treatments for Postherpetic Neuralgia: A Systematic Review. Pain Physician. 2019; 22(3):209-228. View

14.

Kim K, Jo D, Kim E . Pulsed Radiofrequency to the Dorsal Root Ganglion in Acute Herpes Zoster and Postherpetic Neuralgia. Pain Physician. 2017; 20(3):E411-E418. View

15.

Kennedy P, Gershon A . Clinical Features of Varicella-Zoster Virus Infection. Viruses. 2018; 10(11). PMC: 6266119. DOI: 10.3390/v10110609. View

16.

Cahana A, Vutskits L, Muller D . Acute differential modulation of synaptic transmission and cell survival during exposure to pulsed and continuous radiofrequency energy. J Pain. 2003; 4(4):197-202. DOI: 10.1016/s1526-5900(03)00554-6. View

17.

Schmader K . Herpes Zoster. Ann Intern Med. 2018; 169(3):ITC19-ITC31. DOI: 10.7326/AITC201808070. View

18.

Song L, He L, Pei Q, Peng K, Wang N, Guo Z . CT-guided percutaneous radiofrequency thermocoagulation for glossopharyngeal neuralgia: A retrospective clinical study of 117 cases. Clin Neurol Neurosurg. 2019; 178:42-45. DOI: 10.1016/j.clineuro.2019.01.013. View

19.

Matsumoto I, Kamei K, Murase T, Yoshida Y, Kawaguchi K, Matsumoto M . Surgical treatment for chronic pancreatitis: A single-center retrospective study in Japan. J Hepatobiliary Pancreat Sci. 2020; 27(9):632-639. DOI: 10.1002/jhbp.795. View

20.

Li J . Herpes zoster ophthalmicus: acute keratitis. Curr Opin Ophthalmol. 2018; 29(4):328-333. DOI: 10.1097/ICU.0000000000000491. View