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Aoun, Marven, Moussa, Ronald, Daher, Mohammad, Kreichati, Gaby, Kharrat, Khalil, Sebaaly, Amer. (1404). Does Intra-Operative Posterior Facet Steroid Injection in Lumbar Laminectomy Decreases Post-Operative Low Back Pain? A randomized Clinical Trial. , 13(9), 567-571. doi: 10.22038/abjs.2024.81130.3700
Marven Aoun; Ronald Moussa; Mohammad Daher; Gaby Kreichati; Khalil Kharrat; Amer Sebaaly. "Does Intra-Operative Posterior Facet Steroid Injection in Lumbar Laminectomy Decreases Post-Operative Low Back Pain? A randomized Clinical Trial". , 13, 9, 1404, 567-571. doi: 10.22038/abjs.2024.81130.3700
Aoun, Marven, Moussa, Ronald, Daher, Mohammad, Kreichati, Gaby, Kharrat, Khalil, Sebaaly, Amer. (1404). 'Does Intra-Operative Posterior Facet Steroid Injection in Lumbar Laminectomy Decreases Post-Operative Low Back Pain? A randomized Clinical Trial', , 13(9), pp. 567-571. doi: 10.22038/abjs.2024.81130.3700
Aoun, Marven, Moussa, Ronald, Daher, Mohammad, Kreichati, Gaby, Kharrat, Khalil, Sebaaly, Amer. Does Intra-Operative Posterior Facet Steroid Injection in Lumbar Laminectomy Decreases Post-Operative Low Back Pain? A randomized Clinical Trial. , 1404; 13(9): 567-571. doi: 10.22038/abjs.2024.81130.3700

Does Intra-Operative Posterior Facet Steroid Injection in Lumbar Laminectomy Decreases Post-Operative Low Back Pain? A randomized Clinical Trial

The Archives of Bone and Joint Surgery
مقاله 6، دوره 13، شماره 9، آذر 2025، صفحه 567-571    اصل مقاله (710.61 K)
نوع مقاله: RESEARCH PAPER
شناسه دیجیتال (DOI): 10.22038/abjs.2024.81130.3700
نویسندگان
Marven Aoun؛ Ronald Moussa؛ Mohammad Daher؛ Gaby Kreichati؛ Khalil Kharrat؛ Amer Sebaaly*
Hotel Dieu de France, Beirut, Lebanon
چکیده
Objectives: The complexity of low back pain, involving factors like nerve compression and facet arthritis, prompts exploration of additional interventions, such as facet joint steroid infiltration during laminectomy, to potentially enhance post-operative pain relief in spinal stenosis patients.
Methods: This is a multicenter prospective randomized study. Patients were randomly allocated into two groups, one receiving a 2-ml injection of 80mg/2ml methylprednisolone acetate into the facets intraoperatively (n=25), the other receiving no injection (n=25). The Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS) were collected at baseline, and at 1 week, 1 month, and 3 months post-operatively.
Results: Fifty patients were included, 25 in the control group and 25 in the infiltration group. The ODI significantly improved from baseline (32.6 ± 8.6) at 7 days (25.1 ± 7.4), 1 month (19.8 ± 9.9) and 3 months (17.0 ± 10.9) post-operatively in both the control and infiltration group. The NRS significantly improved from baseline at 7 days (2.7 ± 1.9), 1 month (1.7 ± 2.5) and 3 months (1.5 ± 2.5) post-operatively in both groups. No statistically significant difference was noted in ODI or NRS between the two groups at baseline or any of the follow-up timepoints.
Conclusion: Our research indicates that combining steroid infiltration of the facet joints with simple laminectomy does not provide significant advantages beyond possibly expediting recovery. Studies with larger sample sizes are needed to reach the best conclusions for patients with lumbar spinal stenosis.
        Level of evidence: I
کلیدواژه‌ها
Facet articulation؛ Laminectomy؛ Lumbar spinal stenosis؛ Steroid infiltration
مراجع
  1. Mooney V, Robertson J. The facet syndrome. Clin Orthop Relat Res. 1976;(115):149-156.
  2. Borenstein DG. Epidemiology, etiology, diagnostic evaluation, and treatment of low back pain. Curr Opin Rheumatol. 2001;13(2):128-134. doi:10.1097/00002281-200103000-00006.
  3. Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006;332(7555):1430-1434. doi:10.1136/bmj.332.7555.1430.
  4. Walter KL, O’Toole JE. Lumbar Spinal Stenosis. JAMA. 2022;328(3):310. doi:10.1001/jama.2022.6137.
  5. Ma XL, Zhao XW, Ma JX, Li F, Wang Y, Lu B. Effectiveness of surgery versus conservative treatment for lumbar spinal stenosis: A system review and meta-analysis of randomized controlled trials. Int J Surg. 2017;44:329-338. doi:10.1016/j.ijsu.2017.07.032.
  6. Izzo R, Popolizio T, D’Aprile P, Muto M. Spinal pain. Eur J Radiol. 2015;84(5):746-756. doi:10.1016/j.ejrad.2015.01.018.
  7. Cavanaugh JM, Ozaktay AC, Yamashita HT, King AI. Lumbar facet pain: biomechanics, neuroanatomy and neurophysiology. J Biomech. 1996;29(9):1117-1129. doi:10.1016/0021-9290(96)00023-1.
  8. Kwak DG, Kwak SG, Lee AY, Chang MC. Outcome of intra-articular lumbar facet joint corticosteroid injection according to the severity of facet joint arthritis. Exp Ther Med. 2019;18(5):4132-4136. doi:10.3892/etm.2019.8031.
  9. Sae-Jung S, Jirarattanaphochai K. Outcomes of lumbar facet syndrome treated with oral diclofenac or methylprednisolone facet injection: a randomized trial. Int Orthop. 2016;40(6):1091-1098. doi:10.1007/s00264-016-3154-y.
  10. Sebaaly A, Lahoud MJ, Rizkallah M, Kreichati G, Kharrat K. Etiology, Evaluation, and Treatment of Failed Back Surgery Syndrome. Asian Spine J. 2018;12(3):574-585. doi:10.4184/asj.2018.12.3.574.
  11. Lak AM, Abunimer AM, Goedmakers CMW, et al. Single-versus Dual-Attending Surgeon Approach for Spine Deformity: A Systematic Review and Meta-Analysis. Oper Neurosurg. 2021;20(3):233-241. doi:10.1093/ons/opaa393.
  12. Chan CYW, Kwan MK. Perioperative Outcome in Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis: A Prospective Study Comparing Single Versus Two Attending Surgeons Strategy. Spine (Phila Pa 1976). 2016;41(11):E694-E699. doi:10.1097/BRS.0000000000001349.
  13. Halanski MA, Elfman CM, Cassidy JA, Hassan NE, Sund SA, Noonan KJ. Comparing results of posterior spine fusion in patients with AIS: Are two surgeons better than one? J Orthop. 2013;10(2):54-58. doi:10.1016/j.jor.2013.03.001.
  14. Daniels AH, Daher M, Singh M, et al. The Case for Operative Efficiency in Adult Spinal Deformity Surgery: Impact of Operative Time on Complications, Length of Stay, Alignment, Fusion Rates, and Patient Reported Outcomes. Spine (Phila Pa 1976). November 2023. doi:10.1097/BRS.0000000000004873.
  15. Jakola AS, Sørlie A, Gulati S, Nygaard OP, Lydersen S, Solberg T. Clinical outcomes and safety assessment in elderly patients undergoing decompressive laminectomy for lumbar spinal stenosis: a prospective study. BMC Surg. 2010;10:34. doi:10.1186/1471-2482-10-34.
  16. Hasan A, Pearl A, Daher M SK. Patient genetic heterogeneities acting as indicators of post- operative pain and opioid requirement in orthopedic surgery: A systematic review. J Opioid Manag. 2024;20(1):77-85. doi:10.5055/jom.0809.
  17. Metzger CM, Farooq H, Merrell GA, et al. Efficacy of a single, image-guided corticosteroid injection for glenohumeral arthritis. J shoulder Elb Surg. 2021;30(5):1128-1134. doi:10.1016/j.jse.2020.08.008.
  18. Andrade-Silva FB, Carvalho A, Mansano C, et al. Functional results and isokinetic muscle strength in patients with Fraser type I floating knee treated with internal fixation. Injury. 2017;48(6):S2-S5. doi:10.1016/S0020-1383(17)30767-2.
  19. Krez A, Liu Y, Kanbour S, Clare S, Waldman S, Stein EM. The skeletal consequences of epidural steroid injections: a literature review. Osteoporos Int. 2021;32(11):2155-2162. doi:10.1007/s00198-021-05986-4.
  20. El Abd O, Amadera J, Pimentel DC, Gomba L. Immediate and acute adverse effects following transforaminal epidural steroid injections with dexamethasone. Pain Physician. 2015;18(3):277-286.
  21. Kreitz TM, Mangan J, Schroeder GD, et al. Do Preoperative Epidural Steroid Injections Increase the Risk of Infection After Lumbar Spine Surgery? Spine (Phila Pa 1976). 2021;46(3):E197-E202. doi:10.1097/BRS.0000000000003759.
 

 

 

 

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