Local application of steroids following lumbar discectomy

In this prospective randomized clinical study, the effectiveness of epidural steroids to reduce pain following lumbar disc surgery was assessed. Sixty-one patients undergoing lumbar discectomy were included. They were assigned randomly to receive, immediately after removal of the disc, either 80 mg methylprednisolone acetate (Depomedrol) or the same amount (2 mL) of saline. Both were soaked in 2.5 x 2.5 cm of collagen absorbable hemostat (Instat) that was left on the decompressed nerve root. All discs were removed in the same way via unilateral flavectomy. The patients were asked to grade the pain intensity daily in the first 2 weeks and 1 year after surgery. Pain intensity was evaluated by the visual analog scale from 0 to 10, zero being no pain and 10 being the most severe pain. Statistically significant back pain relief was observed on postoperative days 1, 2, 6, and 14 in the study group (the group that received steroids). No difference between the two groups was found 1 year after surgery or when leg pain was compared. No side effects that could be related to the steroids were observed.