ABSTRACT
Background@#Percutaneous transforaminal endoscopic discectomy (PTED) has been widely used in the treatment of lumbar degenerative diseases. Epidural injection of steroids can reduce the incidence and duration of postoperative pain in a short period of time. Although steroids are widely believed to reduce the effect of surgical trauma, the observation indicators are not uniform, especially the long-term effects, so the problem remains controversial. Therefore, the purpose of this paper was to evaluate the efficacy of epidural steroids following PTED. @*Methods@#We searched PubMed, Embase, and the Cochrane Database from 1980 to June 2021 to identify randomized and non-randomized controlled trials comparing epidural steroids and saline alone following PTED. The primary outcomes included postoperative pain at least 6 months as assessed using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). The secondary outcomes included length of hospital stay and the time of return to work. @*Results@#A total of 451 patients were included in three randomized and two nonrandomized controlled trials. The primary outcomes, including VAS and ODI scores, did not differ significantly between epidural steroids following PTED and saline alone. There were no significant intergroup differences in length of hospital stay. Epidural steroids were shown to be superior in terms of the time to return to work (P < 0.001). @*Conclusions@#Intraoperative epidural steroids did not provide significant benefits, leg pain control, improvement in ODI scores, and length of stay in the hospital, but it can enable the patient to return to work faster.
ABSTRACT
Aim To investigate the effect of intrathecal injection(it) of minocycline(MC),a selective microglia inhibitor,on the maintenance of pain in a murine model of cancer pain.Methods Forty-two male C3H/He mice were randomly divided into 3 groups(n=14 each):sham+PBS group was operated and received 10 ?l PBS injection into calcaneus medullary space;sarcoma+PBS group and sarcoma+MC group were operated and received 2?105 sarcoma cells/10 ?l PBS implantation into calcaneus medullary space.On the PID11(post-implantation day 11),10 mice were taken from each group randomly,sarcoma+PBS group and sham+PBS group were received 0.9% NS(5 ?l) it sarcoma+MC group was received MC(1 nmol,5 ?l) it Mechanical pain threshold and cold hyperalgesia assay were measured before and after it at 0.5,1,2,4,8,24 h.The last 4 mice of each group were received a normally non-noxious palpation of the ipsilateral heel 90 min on the PID12 after it,then the animals were killed and L4-6 segment of spinal cord was removed for analysing the c-fos expression(by immunohistochemistry).Results Bone cancer pain decreased the mechanical and cold pain threshold and activated the c-fos expression in the spinal cord;MC it transient attenuated bone cancer pain-induced hyperalgesia and allodynia and suppressed the expression of c-fos protein.Conclusion The activation of microglia in the spinal cord may be involved in the maintenance of bone cancer pian.