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Lumbar radiculopathy caused by conditions such as lumbar disc herniation (LDH) and lumbar spinal stenosis (LSS) 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 (DRG) 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 (pRF) 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 transforaminal epidural steroid injection (TFESI), these interventions may provide enhanced clinical benefit.
Despite the increasing use of combined TFESI and dorsal root ganglion (DRG) pulsed radiofrequency (pRF), there is limited evidence comparing treatment responses across different etiological subgroups. The pathophysiological mechanisms underlying lumbar disc herniation (LDH) and lumbar spinal stenosis (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 transforaminal epidural steroid injection (TFESI) combined with dorsal root ganglion (DRG) pulsed radiofrequency (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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lumbar Disc Herniation | Patients diagnosed with lumbar disc herniation (LDH) who underwent transforaminal epidural steroid injection (TFESI) and dorsal root ganglion (DRG) pulsed radiofrequency (pRF). | ||
| Lumbar Spinal Stenosis | Patients diagnosed with lumbar spinal stenosis (LSS) who underwent transforaminal epidural steroid injection (TFESI) and dorsal root ganglion (DRG) pulsed radiofrequency (pRF). |
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| Measure | Description | Time Frame |
|---|---|---|
| Comparison of change in pain intensity (Numeric Rating Scale, NRS) between lumbar disc herniation and lumbar spinal stenosis | Pain intensity will be assessed using the Numeric Rating Scale (0-10), and changes from baseline at 1 hour and 3 weeks post-procedure will be compared between patients with lumbar disc herniation and lumbar spinal stenosis. | Baseline, 1 hour, and 3 weeks post-procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Radiological severity grading | Radiological findings will be evaluated using established classification systems, including the Pfirrmann grading system for lumbar disc degeneration, the Schizas classification for lumbar spinal stenosis (LSS), and the Michigan State University (MSU) classification for lumbar disc herniation (LDH). | Baseline (based on pre-procedural MRI) |
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Inclusion Criteria:
Exclusion Criteria:
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The study population consists of adult patients aged 18-75 years with lumbar radiculopathy secondary to lumbar disc herniation or lumbar spinal stenosis, who underwent transforaminal epidural corticosteroid injection and dorsal root ganglion pulsed radiofrequency at the Algology Clinic of Marmara University Pendik Training and Research Hospital between November 2024 and November 2025. Patients with a symptom duration of at least 3 months and with available clinical and radiological records are included in the analysis.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Marmara University Faculty of Medicine | Istanbul | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D011843 | Radiculopathy |
| D007405 | Intervertebral Disc Displacement |
| D013130 | Spinal Stenosis |
| ID | Term |
|---|---|
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D013122 | Spinal Diseases |
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| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D006547 | Hernia |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |