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

摘要

Objective:To assess the early curative effect of epidural or intravenous administration of steroids during a percutaneous endoscopic lumbar discectomy (PELD).Methods:28 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.Results:There 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).Conclusion:Patients 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.