Evaluation of preprocedural hemogram parameters and systemic inflammatory indices following combined pulsed radiofrequency and transforaminal epidural steroid injection: a retrospective study

Abstract Background Systemic inflammatory markers aid in predicting outcomes for spinal pathologies. However, their effectiveness in combination with neuromodulation is unclear. This study evaluated preprocedural hemogram parameters and systemic inflammatory indices as predictors of success for standardized combination pulsed radiofrequency (PRF) and transforaminal epidural steroid injection (TFESI) following treatment of lumbar disc herniation (LDH). Methods A retrospective cohort of patients with chronic radiculopathy secondary to LDH underwent a standardized combination of PRF and TFESI. Based on pain relief at 4 weeks post-procedure, patients were stratified into two groups: successful (≥ 50% reduction in the NRS score) and failed (< 50% reduction in the NRS score). Preprocedural systemic inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) were compared between groups. Results No significant differences were observed in the preprocedural NLR, PLR, SII, or SIRI values between the groups ( p > 0.05). Furthermore, in the multivariable logistic regression analysis adjusting for clinical confounders, baseline pain severity (preprocedural NRS) showed an independent negative association with achieving a ≥ 50% reduction in NRS score ( p = 0.036), whereas the duration of pain and red blood cell count lost statistical significance. Conclusion Preprocedural systemic inflammatory indices were not associated with short-term clinical outcomes (≥ 50% NRS reduction at 4 weeks) following combined PRF and TFESI treatment. Although baseline pain severity showed a modest independent association with treatment response, its poor discriminative capacity, alongside retrospective limitations, indicates that routine hematological and clinical parameters are insufficient on their own to reliably predict short-term outcomes. Clinical trial number Not applicable.