Outcomes of a retrospective study on sustained release betamethasone for transient radicular symptoms in patients after Transforaminal Lumbar Interbody Fusion operation

Abstract Background:Transforaminal lumbar interbody fusion(TLIF) operation is a commonly treatment for Lumbar disc herniation(LDH). but some patients had transient radicular symptoms after surgery.At present, some studies believes that the application of steroids is effective in radiculopathy caused by LDH. Method: The patients who with single-level LDH underwent TLIF operation were retrospectively analyzed from March 2017 to July 2019. Patients were divided into observation group（a gelatin sponge with a mixture of 1 ml betamethasone injection + 2 ml 2% lidocaine placed around the spinal nerve roots after decompression） and control group 1（1 ml betamethasone injection + 2ml 2% lidocaine placed around the spinal nerve roots after decompression）、group 2（a gelatin sponge with 3 ml normal saline placed around the spinal nerve roots after decompression）group 3（no anything was placed）. Clinical data such as lasegue sign, postoperative hospital stays, VAS score of leg pain, ODI index, Effective standard and therapeutic effect were collected.Results: A total of 186 patients were finally included,the observation group 46 cases, control group 1: 53 cases, group 2:45 cases, and group 3:42 cases. VAS score of postoperative legs pain in the observation group at the postoperative 1-5 day were significantly lower than those in the control groups (P<0.05). The recovery of Lasegue sign in the observation group were significantly better than the control groups (P<0.05). The average of postoperative hospital stay in the observation was significantly shorter than the control groups. In addition,the unmeration of leukocyte in the four groups postoperative were significantly higher than before operation (P<0.05). the rate of complications in observation group and control groups has no significant difference.The patients in the four groups had basically the same satisfaction with the final efficacy (> 90%) .Conclusion：the use of gelatin sponge sustained-release steroids and other mixed solutions can significantly relieve transient radicular symptoms after TLIF operation,and does not influence the occurrence of postoperative complications.