513: Stratified Outcomes of Short-Term Spinal Cord Stimulation in Zoster-Associated Pain

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic neuropathic pain, Non-pharmacological treatments, Neuromodulation (e.g. TMS, TDCS, FUS, SCS, MCS, DBS, vagus nerve stimulation), Treatment/management

Background and Aims: Zoster-associated pain (ZAP) remains a challenging neuropathic condition with heterogeneous clinical outcomes. Pulsed radiofrequency (PRF) and short-term spinal cord stimulation (st-SCS) are commonly used interventional options, but comparative effectiveness data, particularly across different disease stages and dermatomal involvement, remain limited. This study evaluated real-world treatment outcomes of st-SCS versus PRF using a stratified clinical database analysis.

Methods: We conducted a retrospective cohort study including 186 patients with ZAP treated between July 2022 and February 2024 (st-SCS, n = 96; PRF, n = 90). Pain intensity, neuropathic pain characteristics, quality of life (QoL), medication use, and adverse events were assessed at post-treatment and at 1, 3, 6, and 12 months. Subgroup analyses were performed based on disease duration (1-2 months, 2-3 months, ≥3 months) and dermatomal distribution (cervical, thoracic, abdominal, lumbar/sacral regions).

Results: st-SCS achieved higher rates of ≥50% pain relief compared with PRF at multiple time points, including immediately post-treatment, 1 month, and 3 months. Differences remained favorable for st-SCS at later follow-ups. Stratified analysis demonstrated that st-SCS showed particularly strong benefit in patients treated during the subacute stage and in those with thoracic dermatomal involvement. Neuropathic pain features improved more substantially in the st-SCS group, reflected by lower DN4 scores at 1, 3, and 6 months. QoL domains, including sleep quality, mood, and enjoyment of life, also improved more markedly following st-SCS. Medication reduction and adverse event rates were comparable between treatment groups.

Conclusions: In this real-world cohort, short-term spinal cord stimulation demonstrated greater and more durable analgesic benefit compared with PRF for ZAP, particularly in patients treated early in the disease course and those with thoracic involvement. With comparable safety profiles, these findings support st-SCS as a valuable interventional option and highlight its potential role in stratified management of zoster-associated pain.

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Presenting Author: Fan Lu
Submitting Author: Fan Lu

Senior Author: Fan Lu

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Jun LI: Phd - Department of Pain Management, West China Hospital
• Jiwei Zhong: MD - Department of Pain Management, West China Hospital
• XueHan Li: Phd - Department of Anesthesia & Operation Center, West China Hospital
• Li Song: Phd - Department of Pain Management, West China Hospital
• Ling Ye: Phd - Department of Pain Management, West China Hospital
• Hong Xiao: Phd - Department of Pain Management, West China Hospital