Steroids versus pulsed radiofrequency in treatment of radicular pain due to lumbar disc prolapse: a randomized clinical trial

Abstract

BackgroundBoth lumbar transforaminal epidural steroids (TESs) and dorsal root ganglion pulsed radiofrequency (PRF) are used in the treatment of radiculopathy after lumbar disc prolapse. We try to detect which is more effective.Patients and methodsA total of 90 patients were randomly allocated into two groups: the TESs group, which comprised 45 patients, and the PRF group, also comprising 45 patients. In the first group, transforaminal epidural methylprednisolone was injected on the affected roots at a dose of 24 mg/root and in group PRF for 4 min was done and only 8 mg of methylprednisolone was injected after radiofrequency. Visual analog scale (VAS) was assessed by a blinded pain physician before intervention and 1 week, 4 weeks, 2 months, and 3 months after intervention through telephone calls.ResultsAt 1 week the VAS was significantly reduced in both groups, and there was a nonsignificant difference between the two groups. At 4 weeks the VAS reduction was still significant in both groups but the reduction in group PRF was significant in comparison with the TES group. At 2 months there was a nonsignificant difference between VAS and preintervention value in group TES, whereas it was significant in group PRF either in comparison with preinterventional value or with the TES group. At 3 months, the VAS reduction was significant in group PRF in comparison with group TES.ConclusionPRF of lumbar dorsal root ganglia is more effective than lumbar TES injection up to 3 months of follow-up in patients with radiculopathy due to lumbar disc prolapse.