Inactivated COVID-19 vaccine-related herpes zoster and post-herpetic neuralgia: Three case reports.

Vaccination programs against COVID-19 have been implemented all over the world since December 2020. Beside the common side effects of vaccines, there are also increasing reports of herpes zoster (HZ) activation. In this report, we describe three cases of HZ, one of them with post-herpetic neuralgia (PHN) after receiving inactivated COVID-19 vaccine. The first two patients developed HZ 8 and 10 days after vaccination, respectively. When pain could not be controlled with paracetamol and non-steroidal anti-inflammatories, the patients received weak opioid codeine. In addition, the first patient received gabapentin, and the second patient was applied erector spinae plane block. The third patient was admitted 4 months after the diagnosis of HZ and considered to have PHN and pain palliation was provided with tramadol. Although the exact cause has not yet been fully resolved, increased reports of HZ after vaccination suggests a link between vaccines and HZ. Considering that receiving COVID-19 vaccines will going on, HZ and PHN cases will continue to be seen. More epidemiological studies are needed to further evaluate the relationship between COVID-19 vaccines and HZ.

The effect of cervical spinal cord stimulation on cervical spinal nerve root/brachial plexus injury.

Spinal cord stimulation (SCS) has been used for the treatment of chronic pain for almost 50 years. There have been several reports regarding to thoracic and lumbar SCS, while fewer publications have been documented for cervical SCS administration. In this article, we presented patient satisfaction after cervical SCS application in patients with chronic upper extremity pain. Three patients with cervical spinal nerve root or brachial plexus injury who reported no pain relief with the previous treatment modalities were identified. The patients were performed percutaneous cervical SCS. Cervical SCS implantation was successful in the first and the second patients, and with respect to decrease in VAS scores, analgesic drug requirements, and an increase in their quality of life, while the third patient had no pain relief. Cervical SCS may be an effective treatment option in upper extremity chronic pain syndromes as in the lower extremity pain syndromes treated with thoracolumbar SCS.

Comparison of the eficacy of epidural steroid injection applied in cervical and lumbar regions.

OBJECTIVES: Epidural injections have been used for many years in the treatment of chronic pain in patients with chronic backleg pain and chronic neck-arm pain. We aimed to compare the efficacy of lumbar and cervical epidural steroid injections on pain palliation, duration of pain relief and patient satisfaction. METHODS: This is a Retrospective, observational single-center study. A total of 159 patients (96 females, 63 males) who were performed epidural steroid injections in cervical and lumbar regions were included in the study. The patients were divided into two groups as lumbar epidural steroid injection 'Group 1' and cervical epidural steroid injection 'Group 2'. We retrospectively evaluated the patients for numerical rating scale (NRS) prior and after the injection, the duration of the pain relief, whether any complication occured related to injection and patient satisfaction. RESULTS: 130 patients in Group 1 and 29 patients in Group 2 were evaluated. Median NRS before the procedure: 8 in Group 1, 7 in Group 2 and median NRS after the procedure: 3 in Group 1, 4 in group 2. Patient satisfaction with the procedure 56.15% in Group 1 and 48.62% in Group 2. Mean duration of pain relief 7.23 months in Group 1 and 8.17 months in Group 2. There were no statistically significant difference in the evaluated parameters between the two groups. CONCLUSION: It was observed that the pain relief, duration of pain relief and patient satisfaction were similar for cervical and lumbar epidural steroid injections.