Pulsed radiofrequency treatment on spinal nerve root as an alternative to total hysterectomy for sciatica caused by a large uterine fibroid: a case report and literature review

Background: Uterine fibroids cause various symptoms, with total hysterectomy being the primary treatment. However, most patients do not prefer invasive surgery; moreover, total hysterectomy impairs fertility, underscoring the need for conservative options. Case: We report a case of a 50-year-old woman who experienced persistent left leg pain. Despite treatment for over a year under the suspicion of spinal stenosis, her symptoms did not improve. Magnetic resonance imaging revealed a 7.5-cm uterine fibroid, potentially compressing the sacral nerve. Subsequent left sacral nerve blocks significantly improved the radicular pain. Preferring conservative treatment over surgery, the patient opted for medication following a gynecological consultation due to her proximity to menopause. Pulsed radiofrequency treatment was then applied to the affected nerves, which maintained symptom improvement without additional interventions for 2 years. Conclusions: Pulsed radiofrequency treatment offers an effective alternative to total hysterectomy for managing sciatica caused by uterine fibroids, while avoiding the adverse effects associated with surgical intervention.

Leiomyoma; Uterus; Radiculopathy; Nerve block; Neuromodulation

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