The Utility of Diagnostic Transforaminal Epidural Injection in Selective Percutaneous Endoscopic Lumbar Discectomy for Multilevel Disc Herniation with Monoradicular Symptom: A Prospective Randomized Control Study

Abstract

The aim of this study was to analyze the clinical outcomes of diagnostic transforaminal epidural injection (DTEI) in selective percutaneous endoscopic lumbar discectomy for multilevel disc herniation with monoradicular symptom. A prospective randomized clinical study was performed from November 2013 to January 2018. A total of 99 consecutive patients with multilevel disc herniation and monoradicular symptom were divided randomly into the DTEI (n= 48) or control (n= 51) group based on a random number list. Operation time, blood loss, intraoperative fluoroscopy, and length of hospital stay were recorded and analyzed statistically. Visual analog scale (VAS) scores, Oswestry Disability Index (ODI), and the improved MacNab standard were used to assess the clinical outcomes of the 2 groups. No differences were observed between the 2 groups in aspect of baseline data. The patients of both groups had significant improvement in VAS and ODI scores compared with preoperative value. However, the postoperative VAS and ODI scores of the DTEI group were significantly lower compared with the control group. The clinical outcomes of the DTEI group according to the improved MacNab standard were significantly better than that of the control group. DTEI can improve the clinical outcomes of selective percutaneous endoscopic lumbar discectomy for multilevel disc herniation with monoradicular symptom, through improving the accuracy of confirmation of responsible level.