Modi Hiteshi, Chung Kook Jin, Yoon Hoi Soo, Yoo Hui Sung, Yoo Jung Han
Department of Orthopaedics, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.
Int Orthop. 2009 Jun;33(3):737-43. doi: 10.1007/s00264-008-0547-6. Epub 2008 May 28.
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.
本前瞻性随机病例对照研究旨在确定椎间盘切除术后向受累神经根应用低剂量得宝松的有效性。选取57例L4-5或L5-S1单节段椎间盘突出伴单侧腿痛的患者进行研究,并分为两组。对照组28例患者,类固醇组29例患者。所有患者均在黄韧带切开术后行椎间盘切除术。在类固醇组中,椎间盘切除术后将低剂量40mg得宝松浸泡的明胶海绵应用于受累神经根,而在对照组中,受累神经根既未应用生理盐水也未应用普通明胶海绵。术后,要求患者使用视觉模拟评分法(VAS)评估背痛情况,并使用非配对t检验进行统计学比较。在术后第一个月,术后VAS的统计学差异显著(p<0.0001),随后差异变得不显著。结果表明,局部应用低剂量得宝松有助于减轻椎间盘切除术后的即刻背痛,但长期效果不佳。