Abstract:Epidemiological studies indicate that approximately 30% to 50% of patients with Herpes Zoster will develop Postherpetic Neuralgia (PHN), especially among the elderly population, whith the incidence is higher. The duration of PHN can last for several months or even years, severely affecting the patient's quality of life and mental health. Previous treatment methods for PHN included oral medications, nerve blocks, and neurofrequency, but many patients respond poorly to existing therapies and often experience severe side effects. In recent years, spinal cord stimulation (SCS) has been widely implemented both domestically and internationally for the treatment of early and long-term PHN, providing new hope for patients who are ineffective with traditional treatments. SCS involves implanting electrodes in the epidural space, using electrical stimulation to modulate nerve signals, interrupting the vicious cycle of pain, thereby alleviating pain and improving the patient's quality of life. The electrodes for SCS implantation include paddle lead (PL) and cylindrical lead (CL). Compared to PL, CL implantation uses a percutaneous puncture method, which is less invasive and easier to operate and remove, making it the preferred choice for most pain specialists. This PHN case is complicated by DISH, as the formation of multiple bone spurs in the spine and even complete ossification of the intervertebral space limits the percutaneous CL implantation. The use of single-port coaxial endoscopy for percutaneous CL implantation completes a short-term spinal cord stimulation procedure, providing a new solution for patients who are difficult to puncture directly through the intervertebral space for SCS treatment.
