Treatment of Chronic Lumbosacral Radicular Pain Using Adjuvant Pulsed Radiofrequency: A Randomized Controlled Study.

Objectives The objective of this study was to determine the effects of combining pulsed radiofrequency ( PRF) treatment and transforaminal epidural injection ( TFEI) to treat patients with chronic refractory lumbar radicular pain caused by lumbar spinal stenosis. Study design Randomized control trial. Settings Interventional pain management practice. Method Sixty-two patients were assigned to the study groups ( PRF group = 31; control group = 31). Under fluoroscopic guidance, the RF needle was positioned close to the lumbar dorsal root ganglion. The PRF group received 3 cycles of PRF treatment, and sensory stimulation without RF lesioning was applied to the control group. After PRF or sham lesioning, a local anesthetic with steroid was injected. The primary outcome of a successful response was defined as: 1) ≥50% or 4-point pain reduction in the numerical rating scale ( NRS) without an increase in the Oswestry disability index ( ODI) or medication quantification scale ( MQS), or mean score <4 in the global perceived effect ( GPE) scale; or 2) ≥30% or 2-point pain reduction in NRS with a simultaneous decrease in ODI, MQS, or ≥6 points in the GPE scale. Result The number of patients with successful treatment results was higher in the PRF group at 2 months ( P = 0.032) and 3 months ( P = 0.018). No significant differences were observed in terms of the secondary outcome variables between the 2 groups. Conclusion The TFEI provided significant short-term pain relief and PRF can be applied in conjunction with TFEI to achieve higher treatment efficacy compared with TFEI alone. [ABSTRACT FROM AUTHOR]