Efficacy of Epidural Pulsed Radiofrequency Treatment in Persistent Spinal Pain Syndrome: A Prospective Clinical Study.

Background: Persistent spinal pain syndrome type-2 (PSPS-II) is a chronic condition that is characterized by severe pain and results in disability and a significant reduction in quality of life. Despite the wide range of interventional pain treatments that are applied, depending on the complexity of the etiology, epidural pulsed radiofrequency (EPRF) application has emerged as an approach that has gained popularity in recent years. Objective: The objective of this study is to examine the efficacy of EPRF in patients diagnosed with PSPS-II. Methodology: In this prospectively designed study, patients with PSPS-II who had not responded to conservative treatments and epidural steroid injections were subjected to fluoroscopy-guided EPRF. Patients were evaluated with the Numeric Rating Scale (NRS) for pain severity and the Douleur Neuropathique-4 (DN-4) questionnaire for presence of neuropathic pain before the procedure and at one and three months after. Although the change in NRS score was established as the primary outcome measure, the change in the number of patients with neuropathic pain according to the DN-4 was determined as the secondary outcome measure. Result: In the final analysis, data from 42 patients were evaluated. The analysis of the time-dependent change in NRS revealed a statistically significant reduction in the scores for the first and third months, in comparison with the initial measurement. A significant decrease was observed in the number of patients diagnosed with neuropathic pain according to the DN-4 questionnaire in the first month, in comparison with the baseline. However, no significant change was noted in the third month. Conclusion: The utilization of EPRF for the treatment of chronic radicular pain in the setting of PSPS-II appears to be effective in the short term. Further studies are required to ascertain its long-term effects. Trial Registration: ClinicalTrials.gov identifier: NCT06239857.