Subjective Intraoperative Use of Epidural Steroid Administration Following Discectomy for Herniated Lumbar Discs Is There a Role? - A Randomized Control Trial
University of Missouri-Columbia
Summary
The purpose of this study is to determine a grading system for inflammation in lumbar disc herniation and which groups, if any, benefit most from the administration of an intra-operative epidural steroid.
Description
Intraoperative epidural administration of steroids following discectomy for herniated lumbar disc has been the topic of multiple studies in the literature. The results have been mixed, with the majority of the studies finding some benefit, but outcomes have varied drastically amongst the many studies. The aim of this study is to develop a grading scale for intraoperative assessment of nerve root inflammation to determine if this subjective assessment is an adequate indicator for response to epidural steroids following discectomy. Patients will be allocated randomly preoperatively to the interv…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Presenting to the University of Missouri hospital system - including the University of Missouri Hospital and Missouri Orthopaedic Institute - with a clinical assessment indicative of a lumbar disc herniation * Failed conservative treatment - rest, anti-inflammatory medications, physical therapy * Radiculopathy present - positive tension signs or sensory/motor neurologic deficits present * Recent MRI confirming single-level lumbar disc herniation corresponding to clinical evaluation Exclusion Criteria: * Concomitant spinal stenosis, segmental instability, or spondylolis…
Interventions
- DrugDexamethasone
Patients included in the treatment group will have their surgical site lavaged with dexamethasone at the end of their surgery.
- Drugsaline 0.9%
Patients included in the placebo group will have their surgical site lavaged with sterile saline at the end of their surgery.
Location
- Missouri Orthopaedic InstituteColumbia, Missouri