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

Intervention Effect of Lumbar Transforaminal Epidural Block on the Treatment for Low Back Pain with Radicular Pain

Lumbar transforaminal epidural block (LTEB) is a minimally invasive interventional method, and the interventional effect of LTEB on the treatment of low back pain with radicular pain is not yet clear; therefore, a total of 100 patients with low back pain with radicular pain treated in our hospital from January 2021 to December 2021 were included in this study, and they were divided into two groups of 50 each using a digital double-blind method. The control group was treated conservatively, and the study group was treated with LTEB. Patients' pain was assessed using the numerical rating scale (NRS), and the degree of functional impairment was assessed using the Oswestry disability index (ODI). The results of the study showed comparable differences in NRS scores for low back pain, NRS scores for lower extremities, and ODI scores of patients before treatment (t = 0.071, 0.035, 0.007, P > 0.05). After treatment, patients in the control group had a low back pain NRS score (4.00 ± 0.85), lower extremity NRS score (3.87 ± 0.78), ODI score (58.25 ± 2.53), and low back pain NRS score (2.00 ± 0.54), while the study group had a lower extremity NRS score (2.00 ± 0.50) and ODI score (58.25 ± 2.53) that were statistical significance (t = 0.071, 0.035, 24.218, P < 0.001). In conclusion, treatment with LTEB can effectively reduce the pain and improve the functional impairment of patients with low back pain with radicular pain, which is clinically important.

Application and thinking of minimally invasive transforaminal lumbar interbody fusion in degenerative lumbar diseases

Background

This study sought to investigate the clinical efficacy and safety of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lumbar degenerative diseases.

Methods

The clinical data of 55 patients with lumbar degenerative diseases treated at our hospital from January 2018 to January 2020 were analyzed retrospectively. Of the 55 patients, 35 who underwent MIS-TLIF were included in the MIS-TLIF group, and 20 who underwent posterior lumbar interbody fusion (PLIF) were included in the PLIF group. The visual analogue scale (VAS) score, Oswestry disability index (ODI) score, operation time, incision length, intraoperative bleeding, postoperative drainage, postoperative landing time, postoperative hospital stay, postoperative interbody fusion rate, and complications were compared between the two groups.

Results

The patients in both groups were followed-up for at least 1.5 years (range, 18–30 months; with an average of 27.5±2.6 months). There was no significant difference in the operation time, incision length, intraoperative bleeding, VAS score for low back and leg pain, ODI score, interbody fusion rate, hospitalization expenses, and complication rate between the two groups (P>0.05). One patient had nail failure in the MIS-TLIF group, 1 patient in each group had nerve root irritation, and 1 patient in each group had superficial incision infection and local suture dehiscence. The postoperative drainage volume, postoperative landing time, and postoperative hospital stay of the MIS-TLIF group were less than those of the PLIF group (P<0.05).

Conclusions

Compared to PLIF, the use of MIS-TLIF in the treatment of lumbar degenerative diseases has a number of advantages, including more complete intraoperative hemostasis, less postoperative drainage, earlier landing, and faster discharge, and also significantly improves postoperative lumbar discomfort.