Vigneri S, Sindaco G, La Grua M, et al. - Since clinical evidence on neurophysiological changes subsequent to pulsed radiofrequency (PRF) is still lacking, researchers assessed patients with unilateral chronic lumbosacral L5‐S1 neuropathic radiating pain for sural nerve conduction and Hoffmann reflex (H‐reflex) in soleus muscle after adhesiolysis and PRF. Two cycles of 240 seconds high-voltage PRF and epidural adhesiolysis were given to 17 patients. In both lower limbs, the sural nerve action potential, the ratio of maximum H-reflex to maximum M response (H/M ratio), and pain scores were collected before, immediately after, and 1 month following the procedure. After treatment and at follow‐up, no major differences in sural nerve latency, amplitude, or velocity were found between affected and normal sides. In patients with lumbosacral neuropathic radiating pain, epidural adhesiolysis and PRF of the dorsal root ganglion tend to have a major effect on spinal reflexes. A significant reduction in numericrating scale (NRS) and Douleur Neuropathique 4 Questions scores was observed in 53% of patients reporting pain improvement at follow-up of ≥ 30% over baseline. In the affected limb, the H/M ratio was reduced after PRF and 1 month following treatment. H/M ratio variation and NRS score at follow-up were directly correlated in the treated limb.