Intraoperative anti-inflammatory drugs combined with no drainage after MIS-TLIF in the treatment of recurrent lumbar disc herniation: an RCT

Jinpeng Du,Liang Yan,Junsong Yang,Wentao Wang,Lequn Shan,Dageng Huang,Yong Fan,Dingjun Hao

doi:10.1186/s13018-020-02155-x

Abstract

BackgroundMinimally invasive-transforaminal lumbar interbody fusions (MIS-TLIF), in which the nerve root pain is caused by early postoperative edema reaction, is a common clinical complication. However, there is no effective method to solve this problem. We aimed to use gelatin sponge impregnated with mixed anti-inflammatory drugs combined with no drainage after MIS-TLIF to optimize postoperative effect in the treatment of recurrent lumbar disc herniation (LDH).MethodsFrom June 2018, the middle-aged patients (45–60 years old) with recurrent LDH were recruited. Included patients were treated with MIS-TLIF surgery, and no drainage tube was placed after surgery. All patients were randomly divided into intervention group (gelatin sponge impregnated with mixed anti-inflammatory drugs) and control group (saline was immersed in gelatin sponge as a control).ResultsThe intervention group included 63 cases, and the control group included 65 cases. The length of hospital stays and bedridden period in the intervention group were significantly lower than those in the control group (P < 0.05). The VAS score of low back pain in the intervention group was significantly lower than that of the control group at postoperative days 1–6 (P < 0.05, for all). The VAS scores of leg pain in the intervention group at postoperative days 1–9 were statistically lower than the control group (P < 0.05, for all).ConclusionsApplication of gelatin sponge impregnated with mixed anti-inflammatory drugs combined with no drainage after MIS-TLIF can significantly further optimize the surgical effect of recurrent LDH and shorten the bedridden period and hospital stays, to achieve the purpose of early rehabilitation.Trial registrationChina Clinical Trial Registration Center, ChiCTR1800016236. Registered on May 21, 2018, http://www.chictr.org.cn/listbycreater.aspx

Highlights

Minimally invasive-transforaminal lumbar interbody fusions (MIS-TLIF), in which the nerve root pain is caused by early postoperative edema reaction, is a common clinical complication, and according to previous literature, about 21% of patients with lumbar disc herniation have different degrees of postoperative low back pain and leg pain, and the average Visual analog scale (VAS) score on the first day after surgery was 3.89 ± 1.75 [1]
All included patients were randomly divided into the intervention group and control group
There was no significant difference in VAS scores of low back pain and leg pain between two groups (P > 0.05)

Summary

Introduction

Invasive-transforaminal lumbar interbody fusions (MIS-TLIF), in which the nerve root pain is caused by early postoperative edema reaction, is a common clinical complication, and according to previous literature, about 21% of patients with lumbar disc herniation have different degrees of postoperative low back pain and leg pain, and the average VAS score on the first day after surgery was 3.89 ± 1.75 [1]. Invasive-transforaminal lumbar interbody fusions (MIS-TLIF), in which the nerve root pain is caused by early postoperative edema reaction, is a common clinical complication. We aimed to use gelatin sponge impregnated with mixed anti-inflammatory drugs combined with no drainage after MIS-TLIF to optimize postoperative effect in the treatment of recurrent lumbar disc herniation (LDH)

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