Efficacy and safety of ozone injection into the intervertebral foramen for treating patients with chronic, intractable postherpetic neuralgia: a one-year follow-up study

IntroductionChronic intractable postherpetic neuralgia (PHN) is a significant sequel of herpes zoster and significantly impacts patients’ quality of life. Although some pharmacotherapies, interventional approaches, and neural modulation have been recommended as clinical options, their efficacy is li...

Full description

Saved in:
Bibliographic Details
Main Authors: Jiang-Lin Wang, Hai-Li Li, Xiang-Bo Liu, Jia-Gui Zhao, Dong Huang, Cheng Wu, Jia-Shuang Wang, Jun Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1602689/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849734028818644992
author Jiang-Lin Wang
Jiang-Lin Wang
Hai-Li Li
Xiang-Bo Liu
Jia-Gui Zhao
Dong Huang
Cheng Wu
Jia-Shuang Wang
Jia-Shuang Wang
Jun Chen
Jun Chen
author_facet Jiang-Lin Wang
Jiang-Lin Wang
Hai-Li Li
Xiang-Bo Liu
Jia-Gui Zhao
Dong Huang
Cheng Wu
Jia-Shuang Wang
Jia-Shuang Wang
Jun Chen
Jun Chen
author_sort Jiang-Lin Wang
collection DOAJ
description IntroductionChronic intractable postherpetic neuralgia (PHN) is a significant sequel of herpes zoster and significantly impacts patients’ quality of life. Although some pharmacotherapies, interventional approaches, and neural modulation have been recommended as clinical options, their efficacy is limited. Here, we reported the efficacy and safety of a standardized therapeutic approach with CT-guided intervertebral foramen injection of ozone (IVFO) in patients with chronic intractable thoracic and lumbar (PHN) (n = 56) who had been tolerant or insensitive to first-line drugs, such as gabapentin (GBP) or pregabalin.MethodsVisual analogue scale (VAS), quantitative sensory testing (von Frey filaments only), and infrared thermography were used to identify and quantify the pain intensity, area of mechanical hyperalgesia, and skin temperature in the included patients with PHN before and after IVFO treatment. Moreover, the dosage of and the time to discontinue GBP and complications were also documented after discharge from hospitals.ResultsIn this 1 year follow-up study, the primary endpoint outcomes measured by VAS showed that IVFO treatment resulted in significant relief of spontaneous pain by 59.19% [2.67 ± 0.66] for immediate, 68.18% [2.08 ± 0.89] for half year and 70.79% [1.91 ± 1.19] for 1 year after discharge vs. admission, dramatic decrease in spatial area of mechanical hyperalgesia by 52.35% [3.11 ± 0.70] for immediate and 87.41% [0.82 ± 0.50] for half year after discharge vs. admission and skin temperatures by 63.01% [0.85 ± 0.35] for immediate after discharge vs. admission. Moreover, half of the patients stopped taking GBP 3 months after discharge. No serious complications were reported during the one-year follow-up after IVFO treatment.ConclusionThese results suggest that CT-guided IVFO treatment is a safe and effective interventional approach for the relief of chronic, drug-resistant, thoracic and lumbar PHN.
format Article
id doaj-art-44fcdca542544ebe85e422b395e2d6a6
institution DOAJ
issn 1664-2295
language English
publishDate 2025-05-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Neurology
spelling doaj-art-44fcdca542544ebe85e422b395e2d6a62025-08-20T03:07:54ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-05-011610.3389/fneur.2025.16026891602689Efficacy and safety of ozone injection into the intervertebral foramen for treating patients with chronic, intractable postherpetic neuralgia: a one-year follow-up studyJiang-Lin Wang0Jiang-Lin Wang1Hai-Li Li2Xiang-Bo Liu3Jia-Gui Zhao4Dong Huang5Cheng Wu6Jia-Shuang Wang7Jia-Shuang Wang8Jun Chen9Jun Chen10Department of Pain Management, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, ChinaInstitute for Biomedical Sciences of Pain, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, ChinaDepartment of Anesthesiology, Tianfu Hospital Affiliated to Southwest Medical University, Meishan, Sichuan, ChinaDepartment of Pain Management, The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, ChinaDepartment of Pain Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaDepartment of Pain Management, The Third Xiangya Hospital of Central South University, Changsha, Hunan, ChinaDepartment of Anesthesiology, Hejiang People’s Hospital, Luzhou, Sichuan, ChinaDepartment of Pain Medicine, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, ChinaDepartment of Pain Medicine, Jinshazhou Hospital of Guangzhou Traditional Chinese Medicine, Guangzhou, Guangdong, ChinaInstitute for Biomedical Sciences of Pain, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, China0Sanhang Institute for Brain Science and Technology, School of Medical Research, Northwestern Polytechnical University, Xi’an, Shaanxi, ChinaIntroductionChronic intractable postherpetic neuralgia (PHN) is a significant sequel of herpes zoster and significantly impacts patients’ quality of life. Although some pharmacotherapies, interventional approaches, and neural modulation have been recommended as clinical options, their efficacy is limited. Here, we reported the efficacy and safety of a standardized therapeutic approach with CT-guided intervertebral foramen injection of ozone (IVFO) in patients with chronic intractable thoracic and lumbar (PHN) (n = 56) who had been tolerant or insensitive to first-line drugs, such as gabapentin (GBP) or pregabalin.MethodsVisual analogue scale (VAS), quantitative sensory testing (von Frey filaments only), and infrared thermography were used to identify and quantify the pain intensity, area of mechanical hyperalgesia, and skin temperature in the included patients with PHN before and after IVFO treatment. Moreover, the dosage of and the time to discontinue GBP and complications were also documented after discharge from hospitals.ResultsIn this 1 year follow-up study, the primary endpoint outcomes measured by VAS showed that IVFO treatment resulted in significant relief of spontaneous pain by 59.19% [2.67 ± 0.66] for immediate, 68.18% [2.08 ± 0.89] for half year and 70.79% [1.91 ± 1.19] for 1 year after discharge vs. admission, dramatic decrease in spatial area of mechanical hyperalgesia by 52.35% [3.11 ± 0.70] for immediate and 87.41% [0.82 ± 0.50] for half year after discharge vs. admission and skin temperatures by 63.01% [0.85 ± 0.35] for immediate after discharge vs. admission. Moreover, half of the patients stopped taking GBP 3 months after discharge. No serious complications were reported during the one-year follow-up after IVFO treatment.ConclusionThese results suggest that CT-guided IVFO treatment is a safe and effective interventional approach for the relief of chronic, drug-resistant, thoracic and lumbar PHN.https://www.frontiersin.org/articles/10.3389/fneur.2025.1602689/fullherpes zosterpostherpetic neuralgiaspontaneous painhyperalgesiaintervertebral foramen injection of ozone (IVFO)infrared thermography
spellingShingle Jiang-Lin Wang
Jiang-Lin Wang
Hai-Li Li
Xiang-Bo Liu
Jia-Gui Zhao
Dong Huang
Cheng Wu
Jia-Shuang Wang
Jia-Shuang Wang
Jun Chen
Jun Chen
Efficacy and safety of ozone injection into the intervertebral foramen for treating patients with chronic, intractable postherpetic neuralgia: a one-year follow-up study
Frontiers in Neurology
herpes zoster
postherpetic neuralgia
spontaneous pain
hyperalgesia
intervertebral foramen injection of ozone (IVFO)
infrared thermography
title Efficacy and safety of ozone injection into the intervertebral foramen for treating patients with chronic, intractable postherpetic neuralgia: a one-year follow-up study
title_full Efficacy and safety of ozone injection into the intervertebral foramen for treating patients with chronic, intractable postherpetic neuralgia: a one-year follow-up study
title_fullStr Efficacy and safety of ozone injection into the intervertebral foramen for treating patients with chronic, intractable postherpetic neuralgia: a one-year follow-up study
title_full_unstemmed Efficacy and safety of ozone injection into the intervertebral foramen for treating patients with chronic, intractable postherpetic neuralgia: a one-year follow-up study
title_short Efficacy and safety of ozone injection into the intervertebral foramen for treating patients with chronic, intractable postherpetic neuralgia: a one-year follow-up study
title_sort efficacy and safety of ozone injection into the intervertebral foramen for treating patients with chronic intractable postherpetic neuralgia a one year follow up study
topic herpes zoster
postherpetic neuralgia
spontaneous pain
hyperalgesia
intervertebral foramen injection of ozone (IVFO)
infrared thermography
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1602689/full
work_keys_str_mv AT jianglinwang efficacyandsafetyofozoneinjectionintotheintervertebralforamenfortreatingpatientswithchronicintractablepostherpeticneuralgiaaoneyearfollowupstudy
AT jianglinwang efficacyandsafetyofozoneinjectionintotheintervertebralforamenfortreatingpatientswithchronicintractablepostherpeticneuralgiaaoneyearfollowupstudy
AT hailili efficacyandsafetyofozoneinjectionintotheintervertebralforamenfortreatingpatientswithchronicintractablepostherpeticneuralgiaaoneyearfollowupstudy
AT xiangboliu efficacyandsafetyofozoneinjectionintotheintervertebralforamenfortreatingpatientswithchronicintractablepostherpeticneuralgiaaoneyearfollowupstudy
AT jiaguizhao efficacyandsafetyofozoneinjectionintotheintervertebralforamenfortreatingpatientswithchronicintractablepostherpeticneuralgiaaoneyearfollowupstudy
AT donghuang efficacyandsafetyofozoneinjectionintotheintervertebralforamenfortreatingpatientswithchronicintractablepostherpeticneuralgiaaoneyearfollowupstudy
AT chengwu efficacyandsafetyofozoneinjectionintotheintervertebralforamenfortreatingpatientswithchronicintractablepostherpeticneuralgiaaoneyearfollowupstudy
AT jiashuangwang efficacyandsafetyofozoneinjectionintotheintervertebralforamenfortreatingpatientswithchronicintractablepostherpeticneuralgiaaoneyearfollowupstudy
AT jiashuangwang efficacyandsafetyofozoneinjectionintotheintervertebralforamenfortreatingpatientswithchronicintractablepostherpeticneuralgiaaoneyearfollowupstudy
AT junchen efficacyandsafetyofozoneinjectionintotheintervertebralforamenfortreatingpatientswithchronicintractablepostherpeticneuralgiaaoneyearfollowupstudy
AT junchen efficacyandsafetyofozoneinjectionintotheintervertebralforamenfortreatingpatientswithchronicintractablepostherpeticneuralgiaaoneyearfollowupstudy