World Neurosurg. 2023 Jul 24:S1878-8750(23)01023-9. doi: 10.1016/j.wneu.2023.07.083. Online ahead of print.
ABSTRACT
BACKGROUND: Pain relief in lumbar disc hernias is a challenging condition. This study retrospectively compared particulate steroids, methylprednisolone acetate (mid-term effective), against betamethasone acetate (Long-term effective) on ultrasound-guided caudal epidural injection for lumbar disc herniation (LDH).
METHODS: A total of 40 patients with L4-5 and/or L5-S1 disc herniation were treated with ultrasound-guided caudal epidural injection between September 2021 and June 2022. Nine-teen patients who were given methylprednisolone acetate (group A) as a steroid and a total of 21 patients who were used betamethasone acetate (Group B) were retrospectively collected, and their pain levels and functional improvement were compared retrospectively before, immediately after, and 3 weeks after the injection in terms of the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) as the efficacy value.
RESULTS: There was no statistically significant difference between the groups regarding age, gender, and BMI (p >0.05). In group A, pre-op VAS was 8.84 ± 0.76, immediate post-op period 3.10 ± 1.37, and post-op 3rd week was 4.73 ± 2.32. In group B, the pre-op VAS was 8.76 ±0.76, the post-op early period was 3.14 ± 1.27, and the post-op 3rd week was 3.12 ± 1.30. In group A pre-op ODI was 49.84 ± 9.11 and post-op 3rd week was 22.84 ± 6.44. In group B, the pre-op ODI was 46.71 ± 16.15 and post-op 3rd week was 30.80 ± 17.65. Significant changes were observed in the reduction of VAS values after the procedure in both groups during the early postoperative period and the third week (p-value < 0.05). However, a significant difference was not found between the changes in VAS values between the groups (p-value > 0.005). Similarly, significant changes were observed in the decrease of ODI values after the procedure in both groups during the early postoperative period and the third week (p-value < 0.05). However, no significant difference was observed in the ODI scores between the two groups.
CONCLUSIONS: No significant difference was observed between betamethasone and methylprednisolone. Both steroid groups showed a substantial improvement in the preoperative pain scores of the patients.
PMID:37495099 | DOI:10.1016/j.wneu.2023.07.083
