• Medicine · Mar 2022

    Meta Analysis

    Comparing the efficacy and safety of short-term spinal cord stimulation and pulsed radiofrequency for zoster-related pain: A systematic review and meta-analysis.

    • Song Xue, Wen-Jie Yang, Zhen-Xin Cao, and Tao Sun.
    • Department of Pain Management, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China,Departments of Pain Management, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
    • Medicine (Baltimore). 2022 Mar 18; 101 (11).

    BackgroundPulsed radiofrequency (PRF) is a commonly used method for the treatment of zoster-related pain in the clinic. However, PRF therapy has a high recurrence rate and many adverse reactions. Recent studies have shown that short-term spinal cord stimulation (stSCS) can effectively alleviate zoster-related pain. Due to the lack of evidence, it is unclear whether stSCS is superior to PRF in the efficacy of treating zoster-related pain.ObjectiveThis study aimed to compare the efficacy and safety of stSCS and PRF for zoster-related pain.MethodsWe searched seven electronic databases from the establishment of the database to January 2021. Related randomized controlled trials were included in this meta-analysis. After extracting the data and evaluating the methodological quality of the included trials, the outcome indicators were statistically analyzed by using RevManV.5.3.ResultsThis meta-analysis included 6 trials with a total of 509 patients. Compared with PRF group, stSCS group showed lower pain intensity (standardized mean difference=-0.83, 95%CI [-1.37, -0.30], P=.002), better sleep quality (mean difference=-1.43, 95%CI [-2.29, -0.57], P=.001), lower pain rating index scores, and less incidence of adverse events (RR=0.32, 95%CI [0.12, 0.83], P<.05). However, the efficacies of PRF and stSCS for treating postherpetic neuralgia were consistent in the response rate (RR= 1.10, 95% CI [0.82, 1.48], P=.51) and the complete remission rate (RR=1.05, 95% CI [0.66, 1.68], P=.84).ConclusionsIn this study, stSCS showed a better analgesic effect and higher safety than PRF. Our meta-analysis results suggested that stSCS may be a feasible and safe invasive treatment for zoster-related pain. However, high-quality, randomized controlled trials with large sample sizes are needed to further verify our conclusions.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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