Treatment Response to TFESI and DRG Pulsed RF in Lumbar Spinal Stenosis and Disc Herniation

Overview

Lumbar radiculopathy caused by conditions such as lumbar disc herniation and lumbar spinal stenosis can lead to chronic pain and reduced quality of life. In patients who do not respond to conservative treatments, minimally invasive procedures such as transforaminal epidural steroid injection (TFESI) and pulsed radiofrequency (pRF) applied to the dorsal root ganglion are commonly used. This study aims to compare treatment responses between patients with lumbar disc herniation and those with lumbar spinal stenosis who have undergone TFESI combined with dorsal root ganglion pulsed radiofrequency. Pain levels and clinical outcomes will be evaluated to determine whether the underlying condition affects treatment effectiveness. The results of this study may help guide clinicians in selecting the most appropriate treatment approach for patients with lumbar radiculopathy.

Lumbar radiculopathy is a common clinical condition associated with degenerative spine disorders such as lumbar disc herniation (LDH) and lumbar spinal stenosis (LSS), often resulting in chronic pain and functional limitation. In patients who do not respond adequately to conservative management, minimally invasive interventional procedures are frequently employed. Among these, transforaminal epidural steroid injection (TFESI) and pulsed radiofrequency (pRF) applied to the dorsal root ganglion (DRG) are widely used for pain control. Pulsed radiofrequency is thought to exert its analgesic effect through neuromodulatory mechanisms rather than neurodestruction, including modulation of nociceptive transmission and reduction of neuroinflammatory processes. When combined with TFESI, these interventions may provide enhanced clinical benefit. Despite the increasing use of combined TFESI and DRG pRF, there is limited evidence comparing treatment responses across different etiological subgroups. The pathophysiological mechanisms underlying LDH and LSS differ, with LDH typically involving focal nerve root irritation and LSS characterized by chronic compression and ischemic changes. These differences may influence the effectiveness of interventional treatments. This retrospective study aims to evaluate treatment outcomes in patients who underwent TFESI combined with DRG pRF by categorizing them into two groups based on underlying etiology: lumbar disc herniation and lumbar spinal stenosis. Changes in pain intensity and clinical outcomes will be compared between these groups. The findings are expected to contribute to a better understanding of patient selection and optimization of interventional pain management strategies.