The Efficacy of CT-Guided Pulsed Radiofrequency of the Dorsal Root Ganglion Combined with Methylene Blue Sympathetic Injection on Herpes-Zoster Neuralgia: A Retrospective Study.

OBJECTIVE

This study aimed to investigate the efficacy of Computed Tomography (CT) Guided Pulsed Radiofrequency (PRF) of the Dorsal Root Ganglion (DRG) combined with Methylene Blue (MB) sympathetic injection in acute herpes zoster neuralgia.

BACKGROUND

MB is a nitric oxide synthesis inhibitor that has been reported to exert analgesic and anti-inflammatory properties. In this study, MB was injected to the thoracic or lumbar sympathetic nerve to inhibit sympathetic nerve conduction or destroy nerve endings. This is the first report for thoracic or lumbar sympathetic nerve MB injection.

MATERIALS AND

METHODS

64 patients in study were divided into two groups: PRF combined with sympathetic nerves MB injection group (group A; n = 32,); PRF group (group B; n = 32). The therapeutic effects of each group were compared using the Numeric Rating Scale (NRS) scores and the average doses of Pregabalin (mg/d) immediately after surgery (T1) and at one month (T2), three months (T3), six months (T4), nine months (T5), and twelve months (T6) post-operation. The incidence of postherpetic neuralgia (PHN) and complications in the two groups were observed and enrolled.

RESULTS

No significant differences in general conditions between the two groups. Compared with the preoperative baseline scores (T0), the NRS at T1 to T6 were significantly decreased in both groups. NRS was lower at T1 to T6 in the group A compared with the same times points in group B (P< 0.05). The incidences of PHN in group A were significantly lower at T3 to T6 compared with group B. The daily doses of pregabalin was lower in the A group than B group at T1 to T5, and it was not significantly different at T6 between the two groups. Finally, no adverse complications were recorded in both groups.

CONCLUSION

CT-Guided PRF Combined with MB sympathetic Injection in the treatment of HZ neuralgia is safe and effective, reducing PHN.