Shingles is a neuropathic disease caused by varicella-herpes virus(VZV) invading nerves
and accompanying pain. About 35/1000 people suffer from shingles every year in the
world, and 2.95.8/1000 people over the age of 50 in China suffer from shingles every
year, with an annual growth rate of 2.5~5.0%. If acute herpes zoster can not be treated
effectively, it will be transformed into postherpetic neuralgia (PHN), patients will
suffer long-term knife, needle, burning pain as well as hyperalgesia, touch induced pain
and skin paresthesia, which seriously affect the daily life of patients. It also causes a
huge social and economic burden.Currently, the treatment of postherpetic neuralgia (PHN)
includes medication and minimally invasive interventional therapy. The European
Neurological Association has proposed guidelines for first - and second-line drug
treatment of herpes zoster neuralgia with level A evidence. At the same time, some
patients are relieved by interventional therapy, such as injection therapy (local
injection, peripheral nerve block, stellar ganglion block), nerve stimulation therapy
(percutaneous electrical nerve stimulation, peripheral nerve stimulation, pulsed
radiofrequency), spinal cord stimulation (SCS), and spinal dorsal horn ganglion
destruction.
In 1976, spinal cord stimulation (SCS) was first used to treat patients with nociceptive
pain. It is to place the stimulation electrode around the diseased nerve for a certain
time, frequency, and voltage adjustment, so as to relieve pain. At present, spinal cord
stimulation (SCS) has been widely used and studied in the treatment of postherpetic
neuralgia (PHN) at home and abroad, and its mechanism of action may be related to the
"gate control theory of pain" : in the dorsal horn of the spinal cord, α fiber can
inhibit the pain signal transmitted by C fiber, and spinal cord stimulation (SCS) may
regulate the transmission of pain signal through this mechanism. At the same time, spinal
cord stimulation (SCS) can also affect the levels of gamma-aminobutyric acid and
adenosine in the dorsal horn, thereby reducing neuropathic pain.In patients with herpes
zoster neuralgia treated with spinal cord stimulation (SCS), some patients have
satisfactory pain relief after surgery, but some patients have pain symptoms again some
time after surgery. The reason for this difference in treatment effect is not clear.
Therefore, this study intends to retrospectively analyze the clinical data of patients
with and the risk factors for recurrence after treatment, and then construct a prognostic
prediction model to provide evidence and reference for clinical treatment of postherpetic
neuralgia (PHN).
