Imagine a group of pain specialists in China coming together to settle the debate on using short-term spinal cord stimulation (st-SCS) for treating herpetic-related neuralgia (HN). Through a thorough questionnaire survey, they reached a valuable consensus. They found that st-SCS is highly effective for HN patients who have had symptoms for less than three months. The majority of experts also agreed that st-SCS can be used for HN patients in general, including those with acute herpetic neuralgia (AHN) and early postherpetic neuralgia (PHN). The specialists highlighted the importance of achieving at least 80% paresthesia coverage during test stimulation and recommended a duration of 1-2 weeks for the persistent treatment of st-SCS. These findings not only provide clarity on the clinical use of st-SCS for HN but also emphasize the need for standardized training for pain physicians and further research and studies. Now, you can dive into the full article to explore the details and implications of this exciting consensus!

PurposeShort-term spinal cord stimulation (st-SCS) has been widely used to treat herpetic-related neuralgia (HN) in China for several years, but is still heavily debated as it has no strong evidence in clinical application. Therefore, a questionnaire survey among the Chinese pain specialist workgroup of the Chinese Neuromodulation Society and Chinese Medical Doctor Association was carried out to achieve a consensus about the clinical use of st-SCS for HN treatment.MethodsThe contents of the questionnaire include basic information about doctors (hospital level, work experience, training, procedure numbers, etc.), efficacy, indications, and contraindications of st-SCS, operation conditions, and preoperative preparation of st-SCS, and the prospect of the st-SCS procedure. Initially, the survey was conducted on 110 experts who have practiced the st-SCS procedure from all over the provinces in China. Finally, valuable data was calculated from the 110 questionnaires excluding the doctors with <1 year of experience of st-SCS, <10 cases of procedures per year, and no standard training in SCS technique.ResultsBased on the 110 questionnaires, it is estimated that 5,000 to 10,000 cases of electrical stimulation are carried out nationwide each year. Sixty-nine valid questionnaires acquired from senior pain physicians were more valuable and specialized in the efficacy, indications, and contraindications of st-SCS for HN. It was commonly agreed (97.10%) that the HN patients with <3 months will obtain good effectiveness (patient satisfaction rate ≥50%). Almost all (98.55%) agreed that st-SCS can be used in SHN patients, there was a common agreement (72.46%) that AHN patients are an indication of st-SCS, and more than half agreement (53.62%) that st-SCS may be fit for early PHN (3–6 months). A common agreement (79.71%) was achieved that more than half of HN patients had the experience of nerve block or nerve pulsed RF. A similarly large number of experts 57/69 (82.61%) agreed that an 80% paresthesia coverage should be achieved at the test stimulation and 57/69 (82.61%) agreed that the treatment of st-SCS need be persistent for 1–2 weeks.ConclusionsEarly HN patients can get an effective outcome from the treatment of st-SCS and maybe the indication of st-SCS. Moreover, standardized training for pain physicians and basic research and clinical studies are warranted.

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