Comparison of Percutaneous Transforaminal Endoscopic Discectomy with and without Epidural Steroid Application in the Treatment of Lumbar Disc Herniation: A Minimum of 2 Years of Follow-Up.

Abstract

To compare the efficacy of percutaneous transforaminal endoscopic discectomy with and without epidural steroid application in the treatment of lumbar disc herniation. A total of 101 patients who had indications for percutaneous transforaminal endoscopic discectomy were retrospectively reviewed. Patients were divided into two groups based on whether epidural steroids were applied following the surgical procedure. Each patient in group A received an epidural injection of 40mg triamcinolone acetonide through the working sleeve following the surgical procedure. However, patients in group B were not given the drug. Preoperative and postoperative radicular pain was measured with the visual analogue scale (VAS). Functional and satisfaction outcomes were measured with the Oswestry Disability Index (ODI) and the modified MacNab criteria, respectively. A total of 97 patients had a complete follow-up of longer than two years without recurrence. The sample sizes of group A and group B were 56 and 41. The VAS scores and ODI scores at each postoperative follow-up point were significantly lower than the preoperative values (p < 0.001). However, there were no significant between-group differences (p > 0.05). The secondary outcomes of the changes in the VAS and ODI scores were also equivalent between the groups at the 3-month and 2-year follow-ups (p > 0.05). No significant difference was observed in the modified MacNab criteria between the groups at 2 years (p=0.7715). Percutaneous transforaminal endoscopic discectomy is a safe and effective minimally invasive surgery for radiculopathy caused by lumbar disc herniation. Epidural steroid injection following the surgical procedure offered no benefit compared with surgery alone.