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01-06-2009 | Original Paper

Local application of low-dose Depo-Medrol is effective in reducing immediate postoperative back pain

Authors: Hiteshi Modi, Kook Jin Chung, Hoi Soo Yoon, Hui Sung Yoo, Jung Han Yoo

Published in: International Orthopaedics | Issue 3/2009

Abstract

This prospective, randomised case-control study was made to determine effectiveness of low-dose Depo-Medrol applied to the affected nerve root after discectomy. Fifty seven patients with L4–5 or L5-S1 single level disc herniation with unilateral leg pain were selected for the study and were divided in two groups. Twenty eight patients were in the control group and 29 in the steroid group. Discectomy was done after flavotomy in all patients. In the steroid group low-dose 40 mg Depo-Medrol soaked Gelfoam was applied over the affected nerve root after discectomy while in the control group neither saline nor plain Gelfoam was applied to affected root. Postoperatively, patients were asked to evaluate backache using VAS which was compared statistically using the unpaired t test. Statistical difference was significant (p < 0.0001) regarding postoperative VAS during the first month and then it became insignificant. Results show that local application of low-dose Depo-Medrol is helpful in reducing immediate postoperative backache after discectomy, but it is not effective in the long-term.

Aminmansour B, Khalili HA, Ahmadi J, Nourian M (2006) Effect of high-dose intravenous dexamethasone on postlumbar discectomy pain. Spine 31(21):2415–2417PubMedCrossRef

Berg A (1952) Clinical and myelographic studies of conservatively treated cases of lumbar intervertebral disc protrusion. Acta Chir Scand 104(2–3):124–129PubMed

Boutrand LS, Tadie M (2001) Use of collagen based sealant to prevent in vivo epidural adhesions in an adult rat laminectomy model. J Neurosurg 94:61–67PubMedCrossRef

Buttermann GR (2004) Treatment of lumbar disc herniation: epidural steroid injection compared with discectomy. A prospective, randomized study. J Bone Joint Surg Am 86A(4):670–679

Cherian MN, Mathews MP, Chandy MJ (1997) Local wound infiltration with bupivacaine in lumbar laminectomy. Surg Neurol 47(2):120–122PubMedCrossRef

Debi R, Halperin N, Mirovsky Y (2002) Local application of steroids following lumbar discectomy. J Spinal Disord Tech 15(4):273–276PubMed

Ersayli DT, Gurbet A, Bekar A, Uckunkaya N, Bilgin H (2006) Effects of perioperatively administered bupivacaine and bupivacaine-methylprednisolone on pain after lumbar discectomy. Spine 31(19):2221–2226PubMedCrossRef

Glasser RS, Knego RS, Delashaw JB, Fessler RG (1993) The perioperative use of corticosteroids and bupivacaine in the management of lumbar disc disease. J Neurosurg 78(3):383–387PubMedCrossRef

Jirarattanaphochai K, Jung S, Thienthong S, Krisanaprakornkit W, Sumananont C (2007) Peridural methylprednisolone and wound infiltration with bupivacaine for postoperative pain control after posterior lumbar spine surgery: a randomized double-blinded placebo-controlled trial. Spine 15 32(6):609–616CrossRef

10.

Kawakami M, Tamaki T, Weinstein JN, Hashizume H, Nishi H, Meller ST (1996) Pathomechanism of pain-related behavior produced by allografts of intervertebral disc in the rat. Spine 21(18):2101–2107PubMedCrossRef

11.

King JS (1984) Dexamethasone–a helpful adjunct in management after lumbar discectomy. Neurosurgery 14(6):697–700PubMedCrossRef

12.

Lowell TD, Errico TJ, Eskenazi MS (2000) Use of epidural steroids after discectomy may predispose to infection. Spine 25(4):516–519PubMedCrossRef

13.

Lundin A, Magnuson A, Axelsson K, Kogler H, Samuelsson L (2003) The effect of perioperative corticosteroids on the outcome of microscopic lumbar disc surgery. Eur Spine J 12(6):625–630PubMedCrossRef

14.

Mirzai H, Tekin I, Alincak H (2002) Perioperative use of corticosteroid and bupivacaine combination in lumbar disc surgery: a randomized controlled trial. Spine 27(4):343–346PubMedCrossRef

15.

Mullen JB, Cook WA Jr. (1979) Reduction of postoperative lumbar hemilaminectomy pain with Marcaine. Technical note. J Neurosurg 51(1):126–127

16.

Murphy RW (1977) Nerve roots and spinal nerves in degenerative disc disease. Clin Orthop 129:46–60PubMed

17.

Nachemson A (1969) Intradiscal measurements of pH in patients with lumbar rhinopathies. Acta Orthop Scand 40:23–42PubMedCrossRef

18.

Saal JS, Franson RC, Dobrow R, Saal JA, White AH, Goldthwaite N (1990) High levels of inflammatory phospholipase A2 activity in lumbar disc herniations. Spine 15(7):674–678PubMedCrossRef

Title: Local application of low-dose Depo-Medrol is effective in reducing immediate postoperative back pain
Authors: Hiteshi Modi
Kook Jin Chung
Hoi Soo Yoon
Hui Sung Yoo
Jung Han Yoo
Publication date: 01-06-2009
Publisher: Springer-Verlag
Published in: International Orthopaedics / Issue 3/2009
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-008-0547-6

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Local application of low-dose Depo-Medrol is effective in reducing immediate postoperative back pain

Abstract

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Abstract

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