Use of Local Intraoperative Steroid in MIS TLIF
Use of Local Intraoperative Steroid in MIS TLIF
The purpose of this study is to determine if the frequency and duration of postoperative pain
 are improved in participants receiving a local steroid injection (methylprednisolone) plus a
 systemic (intravenous (IV, by vein)) steroid (dexamethasone) when compared to those receiving
 a systemic (IV) steroid (dexamethasone) alone. Both of these steroid injections are already
 currently used at Rush and are considered standard of practice. It is well established that
 steroids have an anti-inflammatory (decreased swelling) effect on the soft tissue and it is
 routinely used in many types of surgery, but it is not known whether two steroids are better
 than one. The medications provided in this study are approved by the Food and Drug
 Administration (FDA).
Postoperative pain is a well-known complication following minimally invasive transforaminal
 lumbar interbody fusion (MIS TLIF). It has been found that up to 40% of lumbar spinal
 patients will have either recurrent or persistent postoperative pain. Several studies have
 demonstrated reduced patient reported pain scores following steroid administration. However,
 few studies have investigated intraoperative local injection of corticosteroid at the
 surgical site in an effort to reduce the incidence and duration of postoperative pain for MIS
 TLIF patients.

 The purpose of this study is to determine if the incidence and duration of postoperative pain
 is improved in participants receiving a local injection of methylprednisolone with systemic
 dexamethasone when compared to those receiving the usual systemic dexamethasone undergoing
 MIS TLIF.

 The investigators hypothesize that participants undergoing MIS TLIF who receive local
 methylprednisolone along with the systemic dexamethasone will have:

 1. Reduced incidence and duration of postoperative pain compared to participants receiving
 only systemic dexamethasone.

 2. Shorter hospital stay compared to participants receiving only systemic dexamethasone.

 3. Better short- and long-term outcomes compared to participants receiving only systemic
 dexamethasone
Inclusion Criteria:

 -  Patients undergoing a primary 1- to 2-level MIS TLIF

 -  Diagnosis: myelopathy, radiculopathy, myeloradiculopathy, stenosis, herniated nucleus
 pulposus, degenerative disc disease, spondylosis, osteophytic complexes, and foraminal
 stenosis

 -  Patients able to provide informed consent

 Exclusion Criteria:

 -  Allergies or other contraindications to medicines in the protocol including:

 (a) Existing history of gastrointestinal bleeding

 -  Current Smokers

 -  Lumbar spine trauma

 -  Bilateral cages

 -  Lack of consent