Dorsal column stimulator for shingles pain
After the acute phase of inflammation, the virus reaches the sensory nervous system and remains latent in trigeminal or dorsal root ganglions for a long period of time. Herpes zoster is a viral infection caused by human alphaherpesvirus 3, also known as varicella-zoster virus (VZV), the same virus that causes chickenpox in children. A number of alternative invasive treatments of PHN are also discussed. Available information on the pathophysiology of PHN and the effect or stimulation on its course, together with a number of technical nuances concerning various types of neurostimulation are also elucidated in this article.
The article contains a review analysis of 12 articles concerning the current methods of treatment for postherpetic neuralgia including conservative treatment, spinal cord stimulation, and novel neuromodulation strategies. Although the number of patients in alternative SCS studies was very limited, almost all of them showed good responses to therapy with more than 50% VAS improvement and reduction of analgesic dosage.
The mean VAS score improvement was 61.4% with a mean follow-up time of 12.85 months. Long-term pain relief was achieved in 91 patients (67.9%). The full-text analysis allowed us to exclude another 74 articles (fundamental research articles, research utilizing animal subjects, and systemic and nonsystemic reviews) and results of PHN treatment presented with other conditions, leaving 12 articles for the final bibliography.ġ2 articles reporting on the treatment of 134 patients with PHN were analyzed, with a disproportionally large amount of traditional SCS treatment than that to alternative SCS: DRGS (13 patients), burst SCS (1 patient), and high-frequency SCS (2 patients). Initial screening based on abstract and title allowed us to exclude 29 articles (letters, editorials, and conference abstracts). The full text of each article was studied once the abstract was analyzed by the searching reviewer and found appropriate. Bibliographies and references of selected publications on neurostimulation for PHN were further manually screened. There were no publication period limitations.
The search was limited to human studies published in the English language. We searched for articles containing the keywords “spinal cord stimulation AND postherpetic neuralgia,” “high-frequency stimulation AND postherpetic neuralgia,” “burst stimulation AND postherpetic neuralgia” and “dorsal root ganglion stimulation AND postherpetic neuralgia” in Pubmed, Web of Science, and Scopus databases.