Corticosteroids peroperatively diminishes damage to the C-fibers in microscopic lumbar disc surgery

Study Design. A subgroup analysis of patient outcomes from a double-blind randomized controlled study comparing corticosteroid versus saline in microscopic lumbar disc surgery. Objectives. To study if the use of corticosteroids combined with surgery alleviates the damage to the nerve fibers in lumbar disc herniation. Summary of Background Data. The use of quantitative sensory testing can detect damage to the myelinated A-delta fibers ( cold sense) and the unmyelinated C-fibers ( warmth sense). Corticosteroids combined with surgery in lumbar disc surgery enhance the outcome after surgery in terms of less pain and more rapid rehabilitation. Methods. Analyzing quantitative sensory testing before surgery and after 2 weeks and 2 years. Results. In the corticosteroid group, we saw a statistically significant normalization for the warmth disturbance comparing with control group, which not was detected concerning the cold disturbance. Conclusions. The use of corticosteroids combined with surgery seems to protect some of the damage to the C-fibers in lumbar disc herniation.