Factors associated with treatment success after combined transforaminal epidural steroid injection and dorsal root ganglion pulsed radiofrequency treatment in patients with chronic lumbar radicular pain

Abstract

Background/aim The aim of the study is to identify predictors of treatment success with combined transforaminal epidural steroid injection (TFESI) and dorsal root ganglion pulsed radiofrequency (DRG-PRF) in patients with lumbar radicular pain (LRP) associated with lumbar disc herniation. Materials and methods The study included 48 patients with herniation-related LRP who underwent TFESI and DRG-PRF treatment between November 1, 2020 and April 30, 2021. Patient age, sex, symptom duration, history of lumbar surgery, and numeric rating scale (NRS) pain scores before and at 10 days, 1 month, and 3 months after treatment were evaluated retrospectively. Treatment success was defined as ≥50% improvement or a 4-point decrease in NRS score at 3 months. Results Twenty-nine female and 19 male patients with a mean age of 51.54 ± 13.31 years were analyzed. The median symptom duration was 6 (interquartile range: 8.50) months. Symptom duration did not affect treatment success (p = 0.105). History of spinal surgery was more common among patients with failed treatment but was not statistically associated with treatment success. A 1-unit increase in pre-treatment NRS score was associated with 72% lower odds of treatment success (p = 0.022), while a 1-unit increase in NRS score on post-treatment day 10 compared to the pre-treatment value was associated with 95% lower odds of treatment success (p = 0.008). Conclusion Symptom duration and history of spinal surgery were not predictive of treatment success with combined TFESI and DRG-PRF for herniation-related LRP. However, the 3-month prognosis was significantly better for patients with a marked reduction in NRS score at 10 days.

The treatment of persistent spinal pain syndrome with epidural pulsed radiofrequency: improvement of the technique

“…Most of these reports use needle electrodes for the transforaminal route ( 13 , 18–20 ). Among the patients, >50% pain relief was found at follow-up in 45% ( 16 ), 40% ( 13 ), and 33% ( 19 ).…”