Lumbar Disc Herniation, Lumbar Radiculopathy, Lumbar Spinal Stenosis (LSS)
Conditions
Keywords
Lumbar radiculopathy, Transforaminal epidural steroid injection, TFESI, Dorsal root ganglion, Pulsed radiofrequency, DRG pulsed RF, Lumbar disc herniation, Lumbar spinal stenosis, Interventional pain management, Neuromodulation
Brief summary
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.
Detailed description
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.
Interventions
None listed
Sponsors
Marmara University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 75 years * Presence of symptoms associated with lumbar spinal stenosis or lumbar disc herniation * Symptom duration of at least 3 months * Having undergone lumbar transforaminal epidural corticosteroid injection and dorsal root ganglion pulsed radiofrequency
Exclusion criteria
* Absence of sufficient records in the hospital system * Inaccessibility of radiological imaging
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of change in pain intensity (Numeric Rating Scale, NRS) between lumbar disc herniation and lumbar spinal stenosis | Baseline, 1 hour, and 3 weeks post-procedure | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Radiological severity grading | Baseline (based on pre-procedural MRI) | 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). |
Countries
Turkey (Türkiye)
Outcome results
None listed