Transforaminal Epidural Steroid Injection With Pulsed Radiofrequency for Chronic Lumbosacral Radicular Pain Management

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