Objective To investigate the effect of epidural steroid injection(ESI)on the outcome and recurrence after percutaneous endoscopic lumbar discectomy(PELD)for treatment of lumbar disc herniation(LDH).Methods From August 2017 to December 2021,the data of 300 LDH patients who were treated with PELD in Changzheng Hospital of Naval Medical University were retrospectively analyzed.Among them,154 patients treated with PELD before October 2019 were injected with 1 mL steroid hormone during surgery(ESI group);and 146 patients treated with PELD after October 2019 did not undergo ESI during the surgery(control group).The intensity of lower limb pain was assessed by the visual analogue scale(VAS)score at pre-operation,postoperative 1 month and at the final follow-up;the Oswestry disability index(ODI)was used to assess the lumbar spine function at the final follow-up;and the clinical efficacy was evaluated by the modified MacNab criteria at the final follow-up.The occurrence of complications,postoperative recurrence and reoperation were recorded in the 2 groups.Results All the operations were successfully completed.The VAS scores and ODI in the 2 groups were significantly lower than those before surgery at each follow-up time point,and the VAS score at postoperative 2 weeks in the ESI group was significantly lower than that in control group,all with a statistical significance(P<0.05).According to the modified MacNab criteria,there was no significant difference in the rate of excellent and good therapeutic effect between the 2 groups(P>0.05).The recurrence rate of 28 patients who received ESI treatment within 6 weeks before surgery in the ESI group(10.7%,3/28)was higher than that of other patients,but the difference was not statistically significant(P>0.05).There were 3 cases of dural rupture in the ESI group and 2 in the control group,without statistical significance(P>0.05),and no intraoperative cauda equina hernia or postoperative cerebrospinal fluid leakage.Postoperative paresthesia occurred in 3 cases in the ESI group and 10 in the control group,the difference was statistically significant(P<0.05).No complications such as intraoperative nerve root injury,postoperative infection and postoperative hematoma occurred in the 2 groups.During the follow-up period,there were 9 cases of recurrence in the ESI group,of which 4 cases underwent reoperation;and 7 cases of recurrence in the control group,of which 3 cases underwent reoperation;and the difference was not statistically significant(P>0.05).Conclusions Performing ESI during PELD can help relieve early postoperative pain and reduce the incidence of postoperative paresthesia.However,ESI during PELD may increase the risk of recurrence in patients who received ESI within 6 weeks before surgery.
维普
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