Transforaminal Epidural Steroid Injection With Pulsed Radiofrequency for Chronic Lumbosacral Radicular Pain Management
Radicular; Neuropathic, Lumbar, Lumbosacral, Low Back Pain, Back Pain With Radiation
About this trial
This is an interventional treatment trial for Radicular; Neuropathic, Lumbar, Lumbosacral focused on measuring lumbar dorsal root ganglion, transforaminal epidural steroid injection, chronic lumbosacral radicular pain, pulsed radiofrequency treatment, betamethasone, dorsal root ganglion
Eligibility Criteria
Inclusion Criteria:
- men and women
- age ≥18 years old,
- pain intensity≥4 out of 10 on the numerical rating scale (NRS),
- chronic lumbosacral radicular pain lasting ≥12 weeks,
- dominant leg pain with less intense back pain,
- the previous failure of conservative management such as physiotherapy, exercise therapy, or analgesic medications.
- segmental pain of a radicular nature originating from the lumbar segments and with a shooting or lancinating quality corresponding to a dermatome suggestive of the involved nerve root.
- availability of computed tomography/magnetic resonance imaging findings of pathology concordant with the side and level of their clinical features.
Exclusion Criteria:
- patient refusal to participate in the study,
- age <18 years,
- pregnant or nursing
- pain <4-points on NRS,
- acute pain of onset lasting<12 weeks,
- progressive motor weakness in the affected leg,
- allergies to local anesthetics, contrast dyes or steroids
- significant anatomic deformity (either congenital or acquired) making it difficult to access the foramen as evidenced by computed tomography/magnetic resonance imaging
- presence of cancer accounting for back pain
- patients with platelet dysfunction, bleeding disorder or continuing anticoagulant treatment
- steroid injection within the previous 12 weeks,
- systemic infection,
- injection site infection,
- unstable medical or psychiatric condition
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
Other
Celestone
Control
all patients of the experimental Celestone group will receive transforaminal epidural injection of the solution of 1 cc of Lidocaine 1% with 1 cc of Celestone® Chronodose® around each dorsal root ganglion immediately after the radiofrequency treatment has been performed.
all patients of the control group will receive transforaminal epidural injection of the solution of 1 cc of Lidocaine 1% with 1 cc of normal saline around each dorsal root ganglion immediately after the radiofrequency treatment will be performed.