Efficacy Of Neurotropin By Continuous Epidural Injection In The Treatment Of Neuropathic Pain After Percutaneous Transforaminal Endoscopic Discectomy

Background: Lumbar disc herniation(LDH)is the most common cause of adult disorders of loin and leg,percutaneous transforaminal endoscopic discectomy(PTED)is one of the most popular methods for LDH。The neuralgia due to never irritation during the operation is the most common postoperative complication of PTED.However,there is few research on how to prevent neuropathic pain after PTED。Objective: This study consists of two parts:1)The purpose of the first part is to explore the efficacy of neurotropin combined with posteriors ramus of spinal nerve root blook.2)The second part aims to explore if we can treat neuropathic pain after percutaneous transforaminal endoscopic discectomy by neurotropin continuous epidural injecting.Methods:1)103 patients who suffered from low back pain(NTP group,48 cases;steroid group,55 cases)were enrolled in this retrospective study.All patients were followed-up with VAS score and Oswestry disability index.All the patients in both groups were followed up to 12 months after the operation.2)80 patients with lumbar disc herniation who suffered from unilateral sciatica pain were enrolled in this prospective study.They were divided into NTP group(n=34),in which group patients were treated with neurotropin continuous epidural injecting for 2 days after PTED,and control group(n=33),in which group patient were only treated with PTED.All patients were followed-up with VAS score and JOA score for comparison.Results:1)The VAS scores and ODI scores of all patients in both group were significantly decreased after treatment at 1,3,and 6 months postoperatively(all P < 0.01).Comparison of two groups shows no significant differences in VAS scores and ODI scores in each follow-up time point.All patients had no serious complications or adverse reactions during the follow-up time.2)67 patients completed the follow-up(NTP group,n=34;control group,n=33).In The NTP group,compared with control group,shows lower VAS scores and higher JOA scores at 3 days and 7 days postoperatively(all P<0.05),shows higher JOA scores at 2 weeks postoperatively(P<0.05).From 4 weeks to 24 weeks postoperatively,the two groups shows no significant differences in VAS scores and JOA scores(P>0.05).The recovery rate from JOA score shows that NTP group recovery better than control group at 3 days and 7 days postoperatively(P<0.05).During the follow-up time,two cases in control group underwent surgery again because of reherniation,1 case suffer from post-operative dysesthesia for 3 mounths.Conclusions:1)Neurotropin combined with posteriors ramus of spinal nerve root blook showed favorable clinical outcomes for low back pain in lower the degree of pain and improve waist and leg function.2)Neurotropin continuous epidural injecting will relieve patients’ pain earlier and improve waist and leg function earlier after percutaneous transforaminal endoscopic discectomy,without more postoperative adverse events...