Pain physician · 2026
Effects of Burst Spinal Cord Stimulation Versus Those of Paravertebral Block on Thoracic Subacute Herpetic Neuralgia: A Propensity Score-Matched Retrospective Cohort Study.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Zhou Xiao-Kai, Yang Min, Zhu Yun-Qing, Zhu Shi-Yu, Wang Zhong-Yun, Pan Yin-Bing, Yang Jian-Jun
Аннотация
BACKGROUND: Subacute herpetic neuralgia (SHN) is a form of neuropathic pain often accompanied by breakthrough pain (BTP) and paresthesia, leading to impairments in the quality of patients' lives. Although burst spinal cord stimulation (burst-SCS) and thoracic paravertebral block (TPVB) are commonly used in the management of thoracic SHN, the comparative effectiveness of these procedures remains unclear.
OBJECTIVES: This study aimed to compare the clinical effects of burst-SCS to those of TPVB in patients with thoracic SHN.
STUDY DESIGN: A single-center, retrospective cohort study.
SETTING: The First Affiliated Hospital with Nanjing Medical University, People's Republic of China.
METHODS: This retrospective cohort study included 382 patients with thoracic SHN. These individuals were identified through the electronic medical record system. Patients were assigned into either the burst-SCS group or the TPVB group, depending on the intervention they received. Propensity score matching (PSM) was applied to balance baseline characteristics between the 2 groups. Pain intensity, efficacy assessment, incidence of postherpetic neuralgia (PHN), mean number of BTP episodes per day, area and severity of touch-evoked pain, sleep quality, and medication use were assessed at baseline (T0), at discharge (T1), and at one month (T2), 3 months (T3), 6 months (T4), and 12 months (T5) after treatment.
RESULTS: After PSM, 72 matched pairs were generated, with baseline characteristics well balanced between the 2 groups. From T1 to T5, the burst-SCS group demonstrated significantly greater improvement in visual analog scale (VAS) scores than did the TPVB group. Additionally, the cure rate was significantly higher in the burst-SCS group from T1 to T5, as was the response rate at T1 and T2. Moreover, the incidence of PHN was markedly lower in the burst-SCS group than in the TPVB group at T3. Both the area and severity of touch-evoked pain were significantly lower in the burst-SCS group than in the TPVB group from T1 to T5. This finding was consistent with the reduction in the mean number of BTP episodes per day from T1 to T3. At certain follow-up time points, patients in the burst-SCS group exhibited better sleep quality and lower pregabalin consumption than did those in the TPVB group. However, no significant difference was observed between the 2 groups in oral morphine equivalent dosage.
LIMITATIONS: The study design was retrospective and nonrandomized. The findings should not be extrapolated to zoster-associated pain involving other anatomical regions or different disease stages.
CONCLUSION: Both short-term burst-SCS and TPVB were effective in relieving pain and improving sleep quality for patients with thoracic SHN; however, burst-SCS was associated with more favorable clinical outcomes.
OBJECTIVES: This study aimed to compare the clinical effects of burst-SCS to those of TPVB in patients with thoracic SHN.
STUDY DESIGN: A single-center, retrospective cohort study.
SETTING: The First Affiliated Hospital with Nanjing Medical University, People's Republic of China.
METHODS: This retrospective cohort study included 382 patients with thoracic SHN. These individuals were identified through the electronic medical record system. Patients were assigned into either the burst-SCS group or the TPVB group, depending on the intervention they received. Propensity score matching (PSM) was applied to balance baseline characteristics between the 2 groups. Pain intensity, efficacy assessment, incidence of postherpetic neuralgia (PHN), mean number of BTP episodes per day, area and severity of touch-evoked pain, sleep quality, and medication use were assessed at baseline (T0), at discharge (T1), and at one month (T2), 3 months (T3), 6 months (T4), and 12 months (T5) after treatment.
RESULTS: After PSM, 72 matched pairs were generated, with baseline characteristics well balanced between the 2 groups. From T1 to T5, the burst-SCS group demonstrated significantly greater improvement in visual analog scale (VAS) scores than did the TPVB group. Additionally, the cure rate was significantly higher in the burst-SCS group from T1 to T5, as was the response rate at T1 and T2. Moreover, the incidence of PHN was markedly lower in the burst-SCS group than in the TPVB group at T3. Both the area and severity of touch-evoked pain were significantly lower in the burst-SCS group than in the TPVB group from T1 to T5. This finding was consistent with the reduction in the mean number of BTP episodes per day from T1 to T3. At certain follow-up time points, patients in the burst-SCS group exhibited better sleep quality and lower pregabalin consumption than did those in the TPVB group. However, no significant difference was observed between the 2 groups in oral morphine equivalent dosage.
LIMITATIONS: The study design was retrospective and nonrandomized. The findings should not be extrapolated to zoster-associated pain involving other anatomical regions or different disease stages.
CONCLUSION: Both short-term burst-SCS and TPVB were effective in relieving pain and improving sleep quality for patients with thoracic SHN; however, burst-SCS was associated with more favorable clinical outcomes.