Objective To evaluate the effectiveness and safety of CT-guided pulsed radiofrequency（PR） under acupuncture manipulation techniques combined with nerve root block（NRB） for lumbosacral radicular pain（LRP）. Methods Clinical data of 106 LRP patients were retrospectively collected. All the patients underwent CT examination to check the position of the dorsal root ganglion of the responsible nerve root and to determine the puncture point. The radiofrequency cannula was inserted to the skin with hand-grasping insertion method

and was guided by CT to the dorsal root ganglion. When the cannula was approached within 5 mm of dorsal root ganglion

slight and slow twirling method was used（one twirling each second

insertion angle of 10°） till the tip of cannula reached 1 mm within the back of the dorsal root ganglion; from then on

PR combined with NRB were carried out. The lower limbs pain visual analogue scale（VAS） score and Oswestry dysfunction index（ODI） score were assessed before operation

immediately after operation and 1 week

1

3 and 6 months after operation; for the most painful part of the lower limbs

soft tissue tension meter was used to analyze the force displacement distance（FDD） and uptake percentage of energy accounted for measuring work（S） of local soft tissues when a 0.2 kg load was applied; adverse events were recorded. Results The VAS scores were significantly reduced while FDD values and S values increased immediately after operation and 1 week

1

3 and 6 months after operation compared to those before operation（P<0.05）; ODI scores decreased significantly at 1 week

1

3 and 6 months after operation（P<0.05）. No patients had adverse events such as nerve root injury

dural injury

worsening of low back pain and infection during intraoperative period and within 6 months after the operation. Conclusion CT-guided PR under acupuncture manipulation techniques combined with NRB can effectively reduce lower limb pain

improve mobility

reduce soft tissue tension

and is considered to be safe when treating LRP.