小剂量甲泼尼龙在腰椎后路椎体间融合术后治疗坐骨神经痛作用的对照研究

目的观察小剂量甲泼尼龙(MP)在腰椎后路椎体间融合(PLIF)术后对坐骨神经痛是否有效。方法将30例行PLIF的腰椎间盘突出症患者随机分为三组,各10例,A组:术后应用MP160 mg/d,连续6 d;B组:术后应用MP 160 mg/d,连续3 d,以后每天减量40 mg,共应用6 d;C组:不应用,作为对照组。观察三组患者术前及术后6 d的视觉模拟评分。结果三组术前与术后比较下肢视觉模拟评分均显著下降,差异有统计学意义(P<0.05),三组之间比较差异无统计学意义(P>0.05)。所有患者均无明显并发症。结论 PLIF术后应用小剂量MP是安全的,但对腰椎围术期缓解坐骨神经痛无明显帮助,术后下肢疼痛的缓解主要是手术解除了神经根压迫。

A Randomized Single-blind Control Study of Small Dosage Methylprednisolone Applied after Operation of Posterior Lumbar Interbody Fusion for Sciatica

Objective To investigate the effectiveness of small dosage methylprednisolone(MP)applied after operation of posterior lumbar interbody fusion(PLIF)for sciatica.Methods 30 cases of PLIF patients were randomized divided into three groups,10 cases each.MP(160 mg/d)was continuously intravenously used for 6 day after operation in group A;MP(160 mg/d)was continuously intravenously used for 3 day after operation,then in decrement by 40 mg/d in group B;MP was not used in group C as the control group.Results The visual analog scale(VAS)of low limb were significant different(P<0.05)between preoperative and postoperative in all three groups,but no significant difference between the groups(P>0.05).All patients had no significant complications.Conclusion It is safe to use a small dosage of MP intravenously after PLIF operation,no additional benefit for sciatica could be demonstrated,the relief of sciatica was mainly due to the relief of root nerve compression by surgery.