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Background and Aims In this study, we aimed to evaluate the effectiveness of Pulsed Radiofrequency (PRF) and Transforaminal anterior epidural steroid injection (TFAESI) applied to the dorsal root ganglion (DRG) in herpes zoster pain.

Methods The results of patients who underwent DRG PRF and TFAESI for herpes zoster-related pain in the Algology clinic between June 2026 and March 2023 were evaluated retrospectively. Demographic and clinical examination findings (gender, age, involved dermatome, side, neurologic examination, medications used) and VAS scores were recorded. VAS pain scores and complication findings were recorded at 1 month, 6 months and 12 months after the procedure.

Results Datas of 93 patients were evaluated. 66 patients were in acute/subacute pain while 27 patients had postherpetic neuralgia (PHN) at presentation. 11 patients had cervical, 75 patients had thoracic segment involvement, and 7 patients had lumbar segment involvement. Cervical, thoracic and lumbar DRG and TFAESI were performed according to the segment involved. VAS scores for all three regions were significantly lower than pre-procedure at 1 month, 6 months and 12 months after the procedure (p<0.001, p<0.001nvolved DRG, p=0.008, respectively). There was no significant difference for PHN at 6 months and 12 months follow-up (p=0.3, p=0.6). While 2 patients developed nausea and dizziness due to subdural and intravenous leakage after the procedure, no fatal complications were recorded in any patient.

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Abstract OP015 Figure 1

a) Fluoroscopic 45-degree oblique position of the foramen and cannula for cervical DRG and TFAESI b) Fluoroscopic anterior posterior position of the opaque distribution in the anterior epidural space for cervical DRG and TFAESI c) Fluoroscopic lateral position of the cannula in the foramen and opaque distribution for thoracic DRG and TFAESI d) Fluoroscopic anteroposterior position for thoracic DRG and TFAESI image of cannula placement and opaque material distribution in the posterior position

Conclusions In herpes zoster-associated refractory neuropathic pain, fluoroscopy-guided combined DRG and TFEASI application methods provide long-term effective pain control and are safe both in the acute/subacute phase and in patients who develop PHN.