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Erschienen in: International Orthopaedics 3/2009

01.06.2009 | Original Paper

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

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

Erschienen in: International Orthopaedics | Ausgabe 3/2009

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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.
Literatur
1.
Zurück zum Zitat Aminmansour B, Khalili HA, Ahmadi J, Nourian M (2006) Effect of high-dose intravenous dexamethasone on postlumbar discectomy pain. Spine 31(21):2415–2417PubMedCrossRef Aminmansour B, Khalili HA, Ahmadi J, Nourian M (2006) Effect of high-dose intravenous dexamethasone on postlumbar discectomy pain. Spine 31(21):2415–2417PubMedCrossRef
2.
Zurück zum Zitat Berg A (1952) Clinical and myelographic studies of conservatively treated cases of lumbar intervertebral disc protrusion. Acta Chir Scand 104(2–3):124–129PubMed Berg A (1952) Clinical and myelographic studies of conservatively treated cases of lumbar intervertebral disc protrusion. Acta Chir Scand 104(2–3):124–129PubMed
3.
Zurück zum Zitat 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 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
4.
Zurück zum Zitat 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 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
5.
Zurück zum Zitat Cherian MN, Mathews MP, Chandy MJ (1997) Local wound infiltration with bupivacaine in lumbar laminectomy. Surg Neurol 47(2):120–122PubMedCrossRef Cherian MN, Mathews MP, Chandy MJ (1997) Local wound infiltration with bupivacaine in lumbar laminectomy. Surg Neurol 47(2):120–122PubMedCrossRef
6.
Zurück zum Zitat Debi R, Halperin N, Mirovsky Y (2002) Local application of steroids following lumbar discectomy. J Spinal Disord Tech 15(4):273–276PubMed Debi R, Halperin N, Mirovsky Y (2002) Local application of steroids following lumbar discectomy. J Spinal Disord Tech 15(4):273–276PubMed
7.
Zurück zum Zitat 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 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
8.
Zurück zum Zitat 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 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
9.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat King JS (1984) Dexamethasone–a helpful adjunct in management after lumbar discectomy. Neurosurgery 14(6):697–700PubMedCrossRef King JS (1984) Dexamethasone–a helpful adjunct in management after lumbar discectomy. Neurosurgery 14(6):697–700PubMedCrossRef
12.
Zurück zum Zitat Lowell TD, Errico TJ, Eskenazi MS (2000) Use of epidural steroids after discectomy may predispose to infection. Spine 25(4):516–519PubMedCrossRef Lowell TD, Errico TJ, Eskenazi MS (2000) Use of epidural steroids after discectomy may predispose to infection. Spine 25(4):516–519PubMedCrossRef
13.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Mullen JB, Cook WA Jr. (1979) Reduction of postoperative lumbar hemilaminectomy pain with Marcaine. Technical note. J Neurosurg 51(1):126–127 Mullen JB, Cook WA Jr. (1979) Reduction of postoperative lumbar hemilaminectomy pain with Marcaine. Technical note. J Neurosurg 51(1):126–127
16.
Zurück zum Zitat Murphy RW (1977) Nerve roots and spinal nerves in degenerative disc disease. Clin Orthop 129:46–60PubMed Murphy RW (1977) Nerve roots and spinal nerves in degenerative disc disease. Clin Orthop 129:46–60PubMed
17.
Zurück zum Zitat Nachemson A (1969) Intradiscal measurements of pH in patients with lumbar rhinopathies. Acta Orthop Scand 40:23–42PubMedCrossRef Nachemson A (1969) Intradiscal measurements of pH in patients with lumbar rhinopathies. Acta Orthop Scand 40:23–42PubMedCrossRef
18.
Zurück zum Zitat 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 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
Metadaten
Titel
Local application of low-dose Depo-Medrol is effective in reducing immediate postoperative back pain
verfasst von
Hiteshi Modi
Kook Jin Chung
Hoi Soo Yoon
Hui Sung Yoo
Jung Han Yoo
Publikationsdatum
01.06.2009
Verlag
Springer-Verlag
Erschienen in
International Orthopaedics / Ausgabe 3/2009
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-008-0547-6

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