PULSED RADIOFREQUENCY WITH TRANSFORAMINAL EPIDURAL STEROID INJECTION FOR LUMBAR DORSAL ROOT GANGLION: A RETROSPECTIVE STUDY COMPARING GERIATRIC AND YOUNGER PATIENTS WITH RADICULAR PAIN

Introduction: Radicular lower extremity pain is a major cause of disability among geriatric individuals. Pulsed radiofrequency treatment to the dorsal root ganglion and transforaminal epidural steroid injection are minimally invasive therapies. This study evaluated the effectiveness of combination treatments for lower-extremity radicular pain in both geriatric and younger patients and evaluated the effect of paraspinal muscle degeneration on treatment success. Materials and Method: A retrospective analysis of 123 patients with lower extremity radicular pain treated with pulsed radiofrequency treatment to the dorsal root ganglion and transforaminal epidural steroid injection was performed. Patients were assigned to younger (18–64 years) and geriatric (≥ 65 years) groups based on age. Pain intensity was assessed using Numeric Rating Scale before the procedure and at the 12-week follow-up. Fatty infiltration was assessed by lumbar magnetic resonance imaging using the Goutallier classification. Treatment success was defined as a ≥50% reduction in the baseline Numeric Rating Scale score. Results: No postoperative complications were observed. The treatment success rates were 50.7% and 46.4% in the younger and geriatric groups, respectively (p=0.633). Geriatric patients exhibited significantly more fatty degeneration and a longer duration of pain than younger patients. However, these differences did not exhibit an effect on treatment success between the groups. Conclusion: Pulsed radiofrequency treatment combined with transforaminal epidural steroid injection appears to be an effective and safe treatment option for radicular pain regardless of age. Although paraspinal muscle fatty degeneration is more pronounced in older adults, it does not negatively affect the early clinical outcomes. Keywords: Injections, Epidural; Geriatric Assessment; Magnetic Resonance Imaging; Pain Measurement; Pulsed Radiofrequency Treatment; Radiculopathy