[Experience with intra- and perioperative high-dosage steroids in microneursurgical revision operations on lumbar discs.].

UNLABELLED: A consecutive series of 100 microneurosurgical revision operations on lumbar discs has been evaluated in a prospective and randomized clinical trial analyzing the influence of dexamethasone on postoperative clinical outcome. METHODS: Of the 100 patients, 50 received dexamethasone 8 mg by local intrathecal injection during the operation and perioperative dexamethasone by a systemic route for 7 days. A reference group of 50 patients did not receive any steroids. The two groups were compared with reference to postoperative lumbar and radicular pain, regression of paresis, analgesic requirements during hospitalization and duration of stay in hospital. One year after the end of the study clinical results and ability to work in the two groups were compared. RESULTS: A significantly lower analgesic requirement was found in the dexamethasone-treated group. We found no evidence that steroids had ameliorate the regression of paresis or lumbar and radicular pain at the end of hospitalization. There was no difference in the clinical outcome 1 year after reoperation. CONCLUSIONS: After revision operations on lumbar discs, corticosteroids are a helpful adjuvant drug for relief of lumbar or radicular pain, but they do not significantly improve the final clinical outcome.