Application of Gelatin Sponge Impregnated with a Mixture of 3 Drugs to Intraoperative Nerve Root Block to Promote Early Postoperative Recovery of Lumbar Disc Herniation

World Neurosurg. 2018 Jun:114:e1168-e1173. doi: 10.1016/j.wneu.2018.03.170. Epub 2018 Mar 31.

Abstract

Objective: To observe effect of application of gelatin sponge impregnated with a mixture of 3 drugs to intraoperative nerve root block to promote early postoperative recovery of lumbar disc herniation.

Methods: Retrospective analysis was performed of 265 patients with single-level lumbar disc herniation from January 2013 to October 2017. Patients were divided into intervention and control groups based on intraoperative application of gelatin sponge impregnated with a mixture of 3 drugs. All patients underwent unilateral minimally invasive surgical transforaminal lumbar interbody fusion. Clinical data, including bedridden period, postoperative hospital stay, visual analog scale scores for low back pain and leg pain, Japanese Orthopaedic Association score, postoperative satisfaction questionnaire results, and therapeutic effect, were collected.

Results: There were 136 cases in the intervention group and 129 cases in the control group. The intervention group had significantly shorter bedridden period and postoperative hospital stay than control group (P < 0.05). Visual analog scale scores for low back pain and leg pain at postoperative days 1-10 were significantly lower in the intervention group compared with control group (P < 0.05). The Japanese Orthopaedic Association score at postoperative day 6 and satisfaction at 72 hours postoperatively were significantly higher in the intervention group than in control group (P < 0.05). Clinical effect at postoperative day 6 was significantly better in the intervention group than control group (P < 0.05).

Conclusions: Application of gelatin sponge impregnated with a mixture of 3 drugs to intraoperative nerve root block can significantly promote early postoperative recovery of lumbar disc herniation and has great short-term clinical efficacy.

Keywords: Gelatin sponge; Lumbar disc herniation; MIS-TLIF; Nerve root block.

MeSH terms

  • Adult
  • Aged
  • Amides / administration & dosage
  • Anesthetics, Local / administration & dosage
  • Anti-Inflammatory Agents / administration & dosage
  • Dexamethasone / administration & dosage
  • Female
  • Gelatin Sponge, Absorbable / administration & dosage*
  • Humans
  • Intervertebral Disc Displacement / drug therapy*
  • Intervertebral Disc Displacement / surgery*
  • Intraoperative Care / methods
  • Lumbar Vertebrae / injuries
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Pain, Postoperative / prevention & control
  • Postoperative Care / methods
  • Recovery of Function* / drug effects
  • Recovery of Function* / physiology
  • Retrospective Studies
  • Ropivacaine
  • Spinal Nerve Roots / drug effects
  • Spinal Nerve Roots / surgery*
  • Vitamin B 12 / administration & dosage

Substances

  • Amides
  • Anesthetics, Local
  • Anti-Inflammatory Agents
  • Ropivacaine
  • Dexamethasone
  • Vitamin B 12