Turkish Neurosurgery
Intra-operative Results and Post-operative Clinical Outcomes of Lumbar Microdiscectomy in Patients Received Transforaminal Anterior Epidural Steroid Injection Earlier for Lumbar Radiculopathy
Sait Ozturk1, Bekir Akgun1, Fatih Serhat Erol1, Selami Ates Onal2, Metin Kaplan1
1Firat University, School of Medicine, Neurosurgery, Elazig,
2Firat University, School of Medicine, Anesthesiology and Reanimation, Division of Pain Clinic, Elazig,
DOI: 10.5137/1019-5149.JTN.19209-16.1
Aim:We have aimed to describe the intra and postoperative results of patients who received transforaminal anterior epidural steroid injection (TAESI) prior to undergoing lumbar microdiscectomy.Material and Methods:64 of 2461 patients evaluated who had received minimally invasive technique (MIT) for lumbar radiculopathy and who felt no relief after the procedures. 32 patients of them treated with different techniques other than TAESI and those receiving thrombolytic or anticoagulant drugs before microdiscectomy were excluded. We recorded the type of applied MIT, numbers of levels and injections, time interval between the last MIT and microdiscectomy, surgery duration, amount of intraoperative blood loss, rates of incidental durotomies, postoperative infection, and visual analogue scale (VAS) scores for leg pain before and after microdiscectomy at 24 hours, 1. and 3. month (Group 1). A total of 35 patients with no history of MIT or lumbar surgery who had undergone unilateral, single-level lumbar microdiscectomy in our clinic were randomly selected to be included as the control group (Group 2) and same parameters recorded for comparison.Results:The mean duration of lumbar discectomy was 140 minutes, and the amount of average intraoperative blood loss was 227 cc in study group, and 65 minutes and 73 cc, respectively in control group (p>0.05). The comparison of VAS scores revealed that lumbar discectomy was still effective after TAESI (p=0.00).Conclusion:Although epidural steroid injection is an effective modality for managing chronic pain, these patients should be informed preoperatively about the relatively long surgery duration and the possible requirement for transfusion.
Corresponding author : Sait Ozturk