Shingles is a neuropathic disease caused by varicella-herpes virus(VZV) invading nerves and accompanying pain.Currently, the treatment of postherpetic neuralgia (PHN) includes medication and minimally invasive interventional therapy.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.
Shingles is a neuropathic disease caused by varicella-herpes virus(VZV) invading nerves and accompanying pain. About 3\~5/1000 people suffer from shingles every year in the world, and 2.9\~5.8/1000 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).
1. To investigate the pain relief and recurrence of patients with herpes zoster neuralgia after spinal cord stimulation treatment. 2. To analyze the risk factors related to recurrence after spinal cord stimulation treatment in patients with herpes zoster neuralgia, and build a recurrence prediction model.
Tongji Hospital
Wuhan, Hubei, China
Pain recurrence
The diagnostic criteria for pain recurrence at the site of postherpetic neuralgia were Numeric Rating Scales(NRS) score \> 4.
Time frame: up to 1 year
The time of electrodes placed in patients
record the time of spinal cord stimulation in spinal of patients.
Time frame: immediately after the surgery
Surgical safety indicators
record the safety indicators during the spinal cord stimulation surgical ,include the displacement of electrodes and so on.
Time frame: after the surgery 3 days
numeric rating scale(NRS)
The NRS pain Score is an exponential scale that uses 0 to 10 to represent different levels of pain, 0 being painless and 10 being severe, and asks the patient how bad the pain is, or to circle a number that best represents their pain.
Time frame: After spinal cord stimulation surgical 1 year
numeric rating scale(NRS)
The NRS pain Score is an exponential scale that uses 0 to 10 to represent different levels of pain, 0 being painless and 10 being severe, and asks the patient how bad the pain is, or to circle a number that best represents their pain.
Time frame: Day 1 in the hospital
numeric rating scale(NRS)
The NRS pain Score is an exponential scale that uses 0 to 10 to represent different levels of pain, 0 being painless and 10 being severe, and asks the patient how bad the pain is, or to circle a number that best represents their pain.
Time frame: the day before the spinal cord stimulation surgical
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Study Type
OBSERVATIONAL
Enrollment
300
C-reactive protein
An according to early infection stricture in serum.When CRP\>20mg/l is considered abnormally level .
Time frame: Day 1 in the hospital
Albumin
It is a protein that is found in many animal tissues and serum.The normal range 35-50g/L.
Time frame: Day 1 in the hospital
diastolic blood pressure
An indicator in blood pressure measurement that indicates the pressure of the heart's arterial blood against the vessel walls during diastole. It is usually measured in millimeters of mercury (mmHg).
Time frame: Day 1 in the hospital
systolic blood pressure
A type of blood pressure that refers to the pressure of blood against the artery walls when the heart contracts. It is often used as a measure of cardiovascular health(mmHg).
Time frame: Day 1 in the hospital
red blood cell count
The red blood cell count (RBC count) is a measurement of the number of red blood cells present in a microliter (μL) of blood.For males: 4.5 to 5.9 million cells per microliter (μL) of blood.For females: 4.0 to 5.2 million cells per microliter (μL) of blood.
Time frame: Day 1 in the hospital
eosinophilic granulocyte
Eosinophils are a type of white blood cell, specifically a subtype of granulocyte, characterized by the presence of eosinophilic granules in their cytoplasm. The normal range for eosinophils is typically between 0% and 6% of the total white blood cell count, though this can vary slightly depending on the laboratory's reference values and the individual's age and health status.
Time frame: Day 1 in the hospital
erythrocyte sedimentation rate (ESR)
the sedimentation rate or "sed rate," is a test that measures the rate at which red blood cells (erythrocytes) settle in a tube of blood over a specific period of time.
Time frame: Day 1 in the hospital
hemoglobin
Hemoglobin is a protein found in red blood cells that is responsible for transporting oxygen from the lungs to the rest of the body's tissues and organs, and for carrying carbon dioxide back to the lungs for exhalation.The normal range of hemoglobin levels for adult males: 13.8 to 17.2 grams per deciliter (g/dL). adult females: 12.1 to 15.1 g/dL
Time frame: Day 1 in the hospital
neutrophilic granulocyte percentage
The neutrophilic granulocyte percentage, often referred to simply as neutrophil percentage or neutrophil count, is a measure of the proportion of neutrophils in the total white blood cell count.a normal neutrophil percentage typically falls within the range of approximately 40% to 75% of the total white blood cell count.
Time frame: Day 1 in the hospital