Does Intra-Operative Posterior Facet Steroid Injection in Lumbar Laminectomy Decreases Post-Operative Low Back Pain?...

The complexity of low back pain, involving factors like nerve compression and facet arthritis, prompts exploration of additional interventions, such as facet joint steroid infiltration during laminectomy, to potentially enhance post-operative pain relief in spinal stenosis patients.

This is a multicenter prospective randomized study. Patients were randomly allocated into two groups, one receiving a 2-ml injection of 80mg/2ml methylprednisolone acetate into the facets intraoperatively (n=25), the other receiving no injection (n=25). The Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS) were collected at baseline, and at 1 week, 1 month, and 3 months post-operatively.

Fifty patients were included, 25 in the control group and 25 in the infiltration group. The ODI significantly improved from baseline (32.6 ± 8.6) at 7 days (25.1 ± 7.4), 1 month (19.8 ± 9.9) and 3 months (17.0 ± 10.9) post-operatively in both the control and infiltration group. The NRS significantly improved from baseline at 7 days (2.7 ± 1.9), 1 month (1.7 ± 2.5) and 3 months (1.5 ± 2.5) post-operatively in both groups. No statistically significant difference was noted in ODI or NRS between the two groups at baseline or any of the follow-up timepoints.

Our research indicates that combining steroid infiltration of the facet joints with simple laminectomy does not provide significant advantages beyond possibly expediting recovery. Studies with larger sample sizes are needed to reach the best conclusions for patients with lumbar spinal stenosis.