EFFICACY OF INTRA OPERATIVE USE OF TRIAMCINOLONE IN LUMBAR DISCECTOMY

Abstract

Objective: To evaluate the effect of epidural application of triamcinolone during lumbar discectomy on
postoperative pain relief.

Study Design: Case control study.

Place and Duration of Study: Department of Neurosurgery, Combined Military Hospital Lahore, from Oct 2019
to Feb 2020.

Methodology: Thirty patients receiving intraoperative epidural triamcinolone application compared with
30 controls objective assessment by T-scores of the Timed Up and Go test, back and sciatic leg pain by Visual
analog scale and for subjective functional impairment by oswestry Disability Index were calculated pre-op, postoperative day 2 and at 4 weeks.

Results: The baseline demographics, disease specific features and preoperative impairment scores were similar
among both groups. At day post-operative day 2, subjective impairment on oswestry disability index for the
steroid group was (30.6 vs 36.2, p<0.01), with significant difference in terms of objective functional impairment
score between steroid group (T-score 128.2 vs 129.3, p<0.01). At 4 weeks post operatively, the Objective functional impairment was also found to be significantly less in the steroid group (T-score 100.5 vs 110.3, p<0.01), with less disabled steroid group patients with oswestry disability index (17.0 vs 24, p<0.01). Complication rates in both groups were similar. The duration of hospital stay was shorter among the steroid group (5.0 vs 5.8 days, p=0.06).

Conclusion: The application of triamcinolone in lumbar discectomy leads to benefit in both subjective and
objective pain parameters in the early postoperative period.