Title: Functional Outcome of Intervertebral Disc Prolapse Treated with Epidural Steroid and Local Anaesthetic – Prospective Study

Authors: Dr Krishnakumar CV, Dr Sabarisree M, Dr Parthasarathy Naik

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i7.203

Abstract

INTRODUCTION

Disc prolapse amounts for 5% of lower back disorders. Intervertebral disc prolapse can be treated conservatively or surgically.

 The intervertebral disc is subject to continuous and  progressive degenerative changes throughout life, L3,L4,L5 showing greatest degree of degeneration.

References

  1. Mixter W J, Barr J S, 1934: “Rupture of the interve rtebral disc with involvement of spinal canal” N Eng J Med,211:210-2 15.
  2. Smith L; “Enzyme dissolution of nucleus pulposus in humans”. JAMA 1964:187:137.
  3. De Palma A, Rothman R: “Surgery of lumbar spine”. C lin. Orthop.63: 1969;162-170.
  4. Naylor A and Bradford: Late results of laminectomy for lumbar disc prolapsed, JBJS Vol.56B, No.1:1974; Pg17-29.
  5. Erisk V. Spangfor: The lumbar disc herniation. A computer aided analysis of 2504 operations, Acta orthopaedics Scand-inavia supplement. No 142:1972; Pg 5-79.
  6. Salenius P, Laurent L E, 1977; “Results of operativ e treatment of huymbar disc herniation. A survey of 886 patients”. Acta Or thop Scand, 48:630-4.
  7. Rolf Hagen, Lars B: “ Unilateral and bilateral part ial laminectomy in lumbar disc prolapsed:. Acta Orthop.Scand 48: 1977;41-48.
  8. Weir B.K: “ A Prospective study of 100 lumbosacral discectomies”. Journal of Neurosurg. 50: 1979;283-286.
  9. Sharma S,  Sankaran  B,  1980;  “A  clini-cal  profile  of  prolapsed  lumbar interver-tebral disc and its management”. Indian Jou rnal of Orthopaedics, 14(2): 204-212.
  10. Weber H, 1983; “Lumbar disc herniation- A controlle d prospective study with ten years of observation”, Spine, 8:131-140.
  11. Rish B.L: “A critique of surgical management of lum bar disc disease in a private neurosurgical practice”, Spine 9:1984;500-5 03.
  12. Lewis P.J, Weir B.K.A, Broad R.W, Grace M.G.: “Long term prospective study of lumbosacral discectomy:, J.Neurosurg. 67:1987;49-50.
  13. Waddell G.. Reilly S., Torsney B et al: “ Assessmen t of the outcome of low back surgery” J.Bone Joint Surg. 70-B:1988; 723-725.
  14. Silvers H.R. 1988; “Microsurgical versus standard l umbar discectomy”; Neurosurgery: 22(5):837-841.
  15. Sadashisa Hijikata: Percutaneous nucleo-tomy, a new concept techniques abd 12 year experience. CORR,No. 238:1989; Pg 9-23.
  16. Bhalla R and A.K.S. Deane; The results of lumbar intervertebral disc surgery, Indian Journal of Orthopaedics, Vol.23,No.1:Jan 1989.
  17. Gupta S.K. and Ved Prakash: Surgery in lesion of LIVD degeneration Indian journal of orthopaedics, Vol.23,No.1; 1989;Pg 44-49.
  18. Harishchandra and K.P,Srivastava: An assessment of results of surgery in LBP & Sciatica, Indian Journal of Orthopaedics, Vol.24,No.11:Jan 1990,Pg 86-88.
  19. Spengler DM, Quellette E A, Battio M, Zeh J, 1990; “Elective discectomy for herniation of lumbar disc. Additional experience with an objective method”, J Bone Joint Surgery America, 72 A (2): 23 0-32.
  20. Thomas J Errico & David F. Fardon: Open discectomy as treatment for herniated nucleus pulposus of lumbar spine. Spine Vol 20,No.16:1995; Pg 1829-1833.
  21. Advances in endoscopic disc and spine surgery: foraminal approach. Yeung AT, Yeung C A. Arizona Institute for Minimally Invasive Spine Vol 20, No. 16:1995; Pg 1829-1823.
  22. McCulloch J A, 1996; “Focus issue on lumbar disc he rniation : Macro & Micro discectomy”, Spine, 21 (24 suppl):453-568.
  23. Wang J C, Bohlman N H and Riew K D, 1998: “Dural te ars secondary to operation on the lumbar spine: Management and results after a two year minimum follow up of eighty patients”,J Bone Joint Surgery A M, 80 A (12):A28-A32.
  24. Engene J Carragee, Michael Y.Han, Benjamin Yang, David H. Kim “ Activity restriction after posterior lumbar discectomy” a prospective study of outcomes in 152 cases with no post operative restriction. Journal Spine Vol.24, No.22: 1999:Pg 1952-1957.
  25. Kaisuke Takahashi, Iwao shima “Nerve root pressure in lumbar disc herniation” Journal spine, Vol 24,No.19:1999; 2003- 2006.
  26. Fredman B, Nun MB, Zohar E, et al.(Feb 1999). “Epi dural steroids for treating “failed back surgery syndrome”. : is fluor oscopy really necessary ?”. Anesth Analg. 88 (2):367-72.
  27. Gautam Bhattacharya, Arun Seal, N.D.Chaterjee, “Seg mental spinal decompression in lumbar spinal canal stenosis” foll owing long standing.
  28. Varoomen PC, de Krom MC, Knottnerus JA (Feb 2002). “Predicting the outcome of sciatica at short- term follow-up”. Br J Gen Pract 52 (475): 119-23.
  29. Wilco C.Peul, M.D., Hans C.Van Houwelingen, May 2007. “Surgery versus Prolonged Conservative Tratment for Sciatica”. The New England Journal of Medicine; 356:2245-2256.
  30. Morgan-Hough C V J, Jones P W and Eisenstein S M, 2002; “Primary and revision lumbar discectomy; A 16 year review from one center”, J Bone Joint Surgery Br, 85 B(6): 871-874.
  31. T obinick EL, Britschgi-Davoodifar S (Mar 2003). “P erispinal TNF-alpha inhibition for discogenic pain”. Swiss Med Wkly 133 (11-12): 170-7.
  32. Carragee EJ (May 2005). “Clinical practice. Persist ent low back pain”. New England Journal of Medicine 352 (18): 1861-8.
  33. McMillan MR, Crumpton C. Cortical blindness and neurologic injury complicating cervical transforaminal injection for cervical radiculopathy. Anesthesiology. 20063; 99:509-511.
  34. Rozin L, Rozin R, Koehler SA, et al. Death during a transforaminal epidural steroid nerve root block (C7) due to perforation of the left vertebral artery. Am J Forensic Med Path.2003;24:351-355.
  35. Tiso RL,Cutler T, Catania JA,Whalen K. Adverse central nervous system sequelae after selective transforaminal block: The role of corticosteroids. Spine J.2004; 4:468-474.
  36. Brouwers PJAM, Kottnik EJBL, Simon MAM, Prevo RL. A cervical anterior spinal artery syndrome after diagnostic blockade of the right C6-nerve root.Pain.2001;91:397-399.
  37. Baker R, Dreyfuss P, Mercer S, Bogduk N. Cervical transforaminal injection of corticosteroids into a radicular artery: A possible mechanism for spinal cord injry. Pain.2003;103:211-215.
  38. Rathmell JR, Aprill C, Bogduk N. Cervical transforaminal injection of steroids. Anesthesiology. 2004;100:1595-1600.
  39. Tiso RL, Cutler T, Catania JA, Whalen K. Adverse central nervous system sequelae after selective transforaminal block: the role of corticosteroids. Spine J. 2004; 4:468-474.
  40. Derby, R, Date E, Lee CH, Lee JH, Jee SH. Size and aggregation of corticosteroids used for epidural injections. Interventional Spine, ISIS Newsletter. 2005 5(4):30-37.
  41. Okubadejo GO, Talcott MR, Schmidt RE, et al. Perils of intravascular methylprednisolone injection into the vertebral artery: an animal study.J. Bone joint Surg Am.2008;90:1932-1938.
  42. Bogduk N, Dreyfuss P, Baker R, et al. Complications of spinal diagnostic and treatment procedures. Pain Med. 2008;9:S1134.
  43. LoD, Vallee JN, Spell L, et al. Unusual origin of the artery of Adamkiewicz from the fourth lumbar artery. Neuroradiology. 2002;44:153-157
  44. Eldin, N. N., and Senouci, A. B. (1993), “Rubber-Tyreparticles as concrete aggregate.”Journal of Material inCivil Engineering, ASCE, 5(4), 478-496.

Corresponding Author

Dr Sabarisree M

Associate Professor (CAP) in Orthopaedics, 

Govt Medical College, Trivandrum