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Notes:
Volume 6, Issue 4 (Suppl)
J Spine, an open access journal
ISSN: 2165-7939
Page 67
July 24-26, 2017 Rome, Italy
&
Spine and Spinal Disorders
2
nd
International Conference on
Neurology and Neuromuscular Diseases
6
th
International Conference on
CO-ORGANIZED EVENT
The role of epidural steroids in the outcome of postoperative lumbar discectomy
Mohamed Shaban
Cairo University, Egypt
Aim:
Intraoperative epidural corticosteroids have been used by some surgeons to decrease pain following surgery for a herniated
lumbar disc. The objective of this study was to determine if epidural steroid have significant role to improve the outcome of lumber
disc surgery.
Methods:
We retrospectiveevaluated 321 patients who underwent unilateral lumbar discectomy from 2013 to 2016 in Faculty
of Medicine Cairo University. Multiple discectomy, laminectomyor recurrent procedures were excluded from analysis of 321
patient dividedinto two groups:Group(A) 157 patientwith epiduralsteroidpostoperative(40 mg methylprednisolone)group (B)
164 patient without use of steroid. The two groups was evaluated and comparedby pain relief as measured by consumptionof
postoperativepain medications;the lengthof hospitalstay; postoperativefunctionalstatus;and the time intervalfromsurgeryuntil
return to work.
Results:
The mean postoperativeanalgesic medications consumedwas 12.2±1.9 mg of morphine equivalents in the group (A)
versus 12.2±1.8mg of morphineequivalentsin the group (B). The mean hospital stay was less than two days in each group, and
the mean intervaluntil returnto workwas 21±3days in the group(A) versus25±3days in the group(B). Moreover,no statistically
significant difference was measured between both groups. The mean outcome scores, which are derived from a postoperative
assessmentof pain relief resulting from surgery, functionalstatus, and interval until return to work, were identical betweenboth
groups.
Conclusions:
The use of epidural steroid administration after unilateral lumbar discectomy does not lessen postoperative
morbidity or improvefunctionalrecovery. Epiduralsteroiddoes not affect the outcomeof unilaterallumbardiscectomy. Themean
postoperative analgesic medications consumed was 12.2±1.9 mg of morphine equivalents in the corticosteroid group versus
12.2±1.8 mg of morphineequivalentsin the controlgroup. The meanhospitalstay was less than two days in each group, and the
mean interval until return to work was 21.2±2.7 days in the corticosteroidgroup versus 25.4±3.1 days in the control group.
Moreover, no statistically significant difference was measured between the steroid-treatedand control groups when the data
were stratified for sex, age, and site of disc herniation. The mean outcome scores, which are derived from a postoperative
assessment of pain relief resulting from surgery, functional status, and interval until return to work, were identical in the
corticosteroid and control groups. This study concludesthat epidural corticosteroidadministrationafter microsurgicallumbar
discectomyfor unilateraldisc herniationdoes not lessen postoperativemorbidityor improvefunctionalrecovery. The use of a fat
graft results in excellentclinical outcomeswith low incidenceof postoperativecutaneousCSF fistula or other complications.The
use of a fat graft is recommendedas a rapid, effective means of prevention and repair of CSF leaks following lumber spinal
surgery.
Biography
Mohamed Shaban is currently working at Cairo University as a Special Surgeon. He has published many research works.
shabanneuro@gmail.comMohamed Shaban, J Spine 2017, 6:4(Suppl)
DOI: 10.4172/2165-7939-C1-005