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

April 18, 2026 updated by: Haner Direskeneli, Marmara University

Comparison of Treatment Response to Transforaminal Epidural Steroid Injection and Dorsal Root Ganglion Pulsed Radiofrequency in Patients With Lumbar Spinal Stenosis and Lumbar Disc Herniation

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.

Study Overview

Status

Active, not recruiting

Conditions

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.

Study Type

Observational

Enrollment (Actual)

200

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Istanbul, Turkey (Türkiye)
        • Marmara University Faculty of Medicine

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

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.

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
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).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Comparison of change in pain intensity (Numeric Rating Scale, NRS) between lumbar disc herniation and lumbar spinal stenosis
Time Frame: 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.
Baseline, 1 hour, and 3 weeks post-procedure

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Radiological severity grading
Time Frame: 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).
Baseline (based on pre-procedural MRI)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Marmara University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 1, 2024

Primary Completion (Actual)

November 30, 2025

Study Completion (Estimated)

June 1, 2026

Study Registration Dates

First Submitted

March 29, 2026

First Submitted That Met QC Criteria

March 29, 2026

First Posted (Actual)

April 3, 2026

Study Record Updates

Last Update Posted (Actual)

April 22, 2026

Last Update Submitted That Met QC Criteria

April 18, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 09.2026.26-0148

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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