A retrospective study of epidural and intravenous steroids after percutaneous endoscopic lumbar discectomy for large lumbar disc herniation.

Yang Zhang; Xin-jian Yang; Teng-hui Zeng; Yi-yan Qiu; Yi-tian Wang; Fei-guo Liang

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A retrospective study of epidural and intravenous steroids after percutaneous endoscopic lumbar discectomy for large lumbar disc herniation.

Author: Yang ZHANG ¹ ; Xin-Jian YANG ² ; Teng-Hui ZENG ³ ; Yi-Yan QIU ³ ; Yi-Tian WANG ¹ ; Fei-Guo LIANG ³
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1. Clinical School of Shenzhen Second People's Hospital, Anhui Medical University, Hefei 230032, China.
2. Clinical School of Shenzhen Second People's Hospital, Anhui Medical University, Hefei 230032, China
3. Department of Spinal Surgery, Shenzhen Second People's Hospital, Shenzhen 518035, China.
Publication Type:Journal Article
Keywords: Endoscopic lumbar discectomy; Large lumbar disc herniation; Steroids
MeSH: Adult; Betamethasone; administration & dosage; Diskectomy, Percutaneous; methods; Endoscopy; Female; Glucocorticoids; administration & dosage; Humans; Injections, Epidural; Injections, Intravenous; Intervertebral Disc Displacement; surgery; Length of Stay; Lumbar Vertebrae; surgery; Male; Pain Measurement; Retrospective Studies
From: Chinese Journal of Traumatology 2017;20(1):34-38
CountryChina
Language:English
Abstract:
OBJECTIVETo assess the early curative effect of epidural or intravenous administration of steroids during a percutaneous endoscopic lumbar discectomy (PELD).
METHODS28 consecutive patients who underwent PELD due to large lumbar disc herniation between November 2014 and January 2016 were followed up for 6 months. These patients were divided into two groups according to the treatment they received after PELD. 14 patients (Group A) were treated by PELD and epidural steroids, while the other 14 patients (Group B) were treated by PELD and intravenous steroids. We evaluated the effectiveness by the preoperative and postoperative visual analogue scale (VAS) scores for back and leg pain, and the postoperative Oswestry disability index (ODI) at 3 weeks after surgery via the clinical charts and telephone interview. Postoperative hospital stay and time return to work were investigated as well.
RESULTSThere is a significant decrease in VAS (back, leg), ODI, and time return to work (p < 0.05). For VAS (back), Group A showed a significant decrease compared with Group B at 1 day and 1 week after surgery (p = 0.011, p = 0.017). As for VAS (leg), Group A showed a significant decrease compared with Group B at 1 day, 1 week, 3 weeks, and 3 months follow-up examinations (p = 0.002, p = 0.006, p < 0.001, p < 0.001). For ODI, Group A showed a notable decrease compared with Group B (p < 0.001). The postoperative hospital stay in two groups was not statistically different (p = 0.636). But the time return to work in Group A was significantly shorter than that in Group B (p = 0.023).
CONCLUSIONPatients who underwent PELD with epidural steroid administration for large lumbar disc herniation showed favorable curative effect compared with those who underwent PELD with intravenous steroid administration.