[Effect analysis of short-term spinal cord stimulation on segmental zoster paralysis of limbs]

Objective: To investigate the clinical efficacy of short-term spinal cord stimulation (stSCS) in the treatment of segmental zoster paresis (SZP). Methods: A retrospective analysis was performed to collect the clinical data of patients with SZP at the Department of Pain Medicine, Nanjing Hospital Affiliated to Nanjing Medical University from January 2023 to December 2024. The patients were divided into two groups based on whether they received stSCS therapy: the stSCS group (stSCS combined with medication) and the control group (medication only). Evaluations were performed before treatment (T₀) and at the following time points after treatment: day 14 (T₁), 1 month (T₂), 3 months (T₃), and 6 months (T₄). The following parameters were compared between the two groups at different time points: peak torque (PT) of elbow extensors and flexors at an angular velocity of 60°/s, motor nerve conduction velocity (MNCV) of the ulnar and median nerves, as well as scores on the Numerical Rating Scale (NRS) of pain, Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS). Results: The stSCS group consisted of 20 patients (8 males, 12 females) with a median [Q₁, Q₃] age of 73.5 (70.3, 77.3) years and disease duration of 0.9 (0.3, 1.6) months. The control group included 20 patients (6 males, 14 females) with a median age of 69.5 (64.5, 79.0) years and disease duration of 0.7 (0.4, 1.2) months. There were no statistically significant differences in age or gender between the two groups (all P>0.05). At the T₃ and T₄ follow-ups after treatment, the stSCS group demonstrated significantly higher elbow extensor PT [(24.7±1.8) Nm vs (21.9±2.3) Nm], flexor peak PT [(18.6±2.0) Nm vs (20.6±1.9) Nm], ulnar nerve MNCV [(49.0±1.8) m/s vs (52.4±2.3) m/s], and median nerve MNCV [47.3 (46.7, 48.1) m/s vs 51.1 (49.4, 52.1) m/s] compared to the control group, while NRS of pain, SAS, and SDS scores were significantly lower than those in the control group, with significant differences (all P<0.05). No serious stSCS-related adverse reactions occurred, and there were no patient deaths. Conclusion: The stSCS facilitates the recovery of motor function, significantly alleviates pain, and effectively mitigates anxiety and depression symptoms in patients with SZP.