Cutaneous Silent Period-Based Comparison of Dorsal Root Ganglion Pulsed Radiofrequency and Transforaminal Epidural Steroid Injection in Lumbar Radicular Pain: A Randomized Controlled Trial.
Ahmet Başarı, Halil Can Alaydın, Mehmet Fatih Göl
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In 30 seconds
This prospective, single-blind randomized controlled trial compared dorsal root ganglion pulsed radiofrequency (DRG-PRF) with transforaminal epidural steroid injection (TFESI) in 36 patients with chronic unilateral lumbar radicular pain from disc herniation; 18 pain-free volunteers served as controls. At baseline, cutaneous silent period (CSP) duration was shorter in both patient groups than in controls. Both treatments improved pain intensity and disability (P <0.001), with no between-group difference. CSP duration increased after DRG-PRF on day 1 and week 1, but did not change significantly after TFESI.
Key findings
- Baseline CSP duration was shorter in both patient groups than in controls (P =0.024 and P =0.022, respectively).
- Pain intensity and disability improved with both treatments (P <0.001), with no significant between-group difference.
- CSP duration increased after DRG-PRF on day 1 and week 1 (P =0.001 and 0.004, respectively); TFESI produced no statistically significant CSP changes.
Why it matters
The findings distinguish clinical improvement from changes in a physiological measure: both interventions improved pain and disability, while only DRG-PRF altered CSP duration. This supports further study of CSP as a measure of spinal inhibition and a possible tool for investigating mechanisms of interventional pain treatments, rather than relying on symptom outcomes alone.
What to keep in mind
The trial included 36 patients and followed outcomes only through month 1, limiting the evidence on longer-term effects.