A non-operative treatment option for severe lumbar spinal stenosis in patients medically contraindicated for surgery: caudal pulsed radiofrequency outcomes

Aims: Surgical decompression is considered the standard treatment for severe lumbar spinal stenosis (LSS). However, many elderly patients are deemed unsuitable for surgery or high-volume epidural steroid injections due to extensive canal narrowing and significant comorbidity burden. Caudal epidural pulsed radiofrequency (PRF) may serve as a minimally invasive alternative in this clinically challenging subgroup. This study aimed to evaluate the clinical efficacy and safety of caudal epidural PRF in patients with severe LSS who are contraindicated for surgery and epidural steroid injection. Methods: This retrospective single-center study included 32 patients with MRI-confirmed severe LSS (dural sac cross-sectional area