• Sang-Ha Shin, Byeong-Wook Hwang, Han-Joong Keum, Sang-Jin Lee, Sang-Joon Park, and Sang-Ho Lee.
• *Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea; and †Department of Neurosurgery, Busan Wooridul Spine Hospital, Busan, Korea.
• Spine. 2015 Aug 1; 40 (15): E859-65.

Study DesignRandomized controlled study from a single surgeon.ObjectiveThe objective of the present study is to assess the effectiveness of the administration of epidural steroids in patients who undergo a percutaneous endoscopic lumbar discectomy (PELD) because of a herniated lumbar disc.Summary Of Background DataSteroids are drugs that show strong anti-inflammatory effects; in specific, the effects of epidural steroid application after an open lumbar discectomy have been studied extensively. However, no study has been conducted on the effects of perioperative epidural steroids after PELD.MethodsOne hundred patients who had undergone a PELD because of a herniated lumbar disc were randomized into 2 groups. Patients in group 1 were subjected to an epidural steroid application after a PELD, whereas patients in group 2 were treated with saline after a PELD.ResultsThere was a significant decrease in visual analogue scale (VAS) scores (back, leg) and Oswestry Disability Index at all examinations (P < 0.01). When comparing the 2 groups, group 1 showed lower levels of VAS scores (back) in all examinations than group 2 but was not statistically significant (P = 0.257). In VAS score (leg), group 1 showed a significant decrease compared with the group 2 at 1 and 4 weeks of follow-up examination (P = 0.020, P = 0.032). In Oswestry Disability Index, group 1 showed a significant decrease compared with the group 2 at 1-week follow-up examination (P < 0.01).The mean hospital stay was statistically significantly shorter in group 1 (P < 0.01). The mean periods before returning to work for those who returned to work in group 1 and group 2 were 4.45 ± 3.59 weeks and 6.48 ± 4.88 weeks, respectively, when measured at follow-up at 6 months; the period in group 1 was statistically significantly shorter (P = 0.024).ConclusionEpidural steroids after a PELD reduce back pain and leg pain while improving functional outcomes in the short-term postsurgery period.Level Of Evidence2.

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