Outcomes of Single versus Repeated High-Voltage Pulsed Radiofrequency for Thoracic Herpes Zoster Neuralgia in Patients with Diabetes Mellitus: A Retrospective Study.
Patients with herpes zoster neuralgia (HZN) and comorbid diabetes mellitus (DM) often experience persistent pain that markedly undermines quality of life. Most of these patients respond poorly to oral anticonvulsants or conventional pulsed radiofrequency (PRF). Repeated application of high-voltage PRF may offer superior clinical benefits and improve patient satisfaction.
This retrospective study aimed to analyze the outcomes of single versus repeated high-voltage PRF for thoracic HZN in patients with DM.
We retrospectively analyzed data from 109 thoracic HZN patients with DM who underwent CT-guided high-voltage PRF targeting the thoracic selective dorsal root ganglia (DRG) during a one-week hospitalization period. Outcome measures included the incidence of clinically meaningful postherpetic neuralgia (PHN) and the HbA1c level at 12 weeks post-PRF, Numeric Rating Scale (NRS) score, Pittsburgh Sleep Quality Index (PSQI) score at baseline (pre-PRF) and 1, 4, 8, and 12 weeks following PRF (post-PRF), and the adverse events associated with PRF.
56 patients received the single high-voltage PRF group (one PRF session, Group SHV-PRF) and 53 patients received the repeated high-voltage PRF group (two PRF sessions, Group RHV-PRF). The incidence of clinically meaningful PHN at 12 weeks post-PRF was lower in group RHV-PRF than in group SHV-PRF (20.8%vs 41.1%, P < 0.05). NRS and PSQI scores were lower in group RHV-PRF than in group SHV-PRF at 1, 4, 8, and 12 weeks post-PRF (P < 0.05). The HbA1c level at 12 weeks post-PRF was lower in group RHV-PRF than in group SHV-PRF (P<0.05). No severe adverse events were recorded in either group.
Repeated high-voltage pulsed radiofrequency confers favorable therapeutic outcomes for thoracic herpes zoster neuralgia in patients with diabetes mellitus, with an acceptable safety profile.
This retrospective study aimed to analyze the outcomes of single versus repeated high-voltage PRF for thoracic HZN in patients with DM.
We retrospectively analyzed data from 109 thoracic HZN patients with DM who underwent CT-guided high-voltage PRF targeting the thoracic selective dorsal root ganglia (DRG) during a one-week hospitalization period. Outcome measures included the incidence of clinically meaningful postherpetic neuralgia (PHN) and the HbA1c level at 12 weeks post-PRF, Numeric Rating Scale (NRS) score, Pittsburgh Sleep Quality Index (PSQI) score at baseline (pre-PRF) and 1, 4, 8, and 12 weeks following PRF (post-PRF), and the adverse events associated with PRF.
56 patients received the single high-voltage PRF group (one PRF session, Group SHV-PRF) and 53 patients received the repeated high-voltage PRF group (two PRF sessions, Group RHV-PRF). The incidence of clinically meaningful PHN at 12 weeks post-PRF was lower in group RHV-PRF than in group SHV-PRF (20.8%vs 41.1%, P < 0.05). NRS and PSQI scores were lower in group RHV-PRF than in group SHV-PRF at 1, 4, 8, and 12 weeks post-PRF (P < 0.05). The HbA1c level at 12 weeks post-PRF was lower in group RHV-PRF than in group SHV-PRF (P<0.05). No severe adverse events were recorded in either group.
Repeated high-voltage pulsed radiofrequency confers favorable therapeutic outcomes for thoracic herpes zoster neuralgia in patients with diabetes mellitus, with an acceptable safety profile.