A single-center randomized trial in 71 patients compared thermosensitive poloxamer hydrogel with methylprednisolone after full-endoscopic lumbar discectomy. Extensive epidural fibrosis on MRI was less frequent, but leg pain, back pain, and disability did not differ through 12 months; the imaging benefit did not translate into patient-reported benefit.
Key findings
- Both groups improved. At 12 months, VAS-leg decreased 5.91 versus 5.92 (p=0.995), VAS-back 2.17 versus 2.06, and ODI 15.13 versus 15.15, without between-group differences. Grade 3-4 fibrosis was 8.7% with hydrogel versus 32% with control (p=0.047); adverse events were rare and comparable.
Why this matters globally
The study provides initial human evidence for an anti-adhesion material in endoscopic surgery and underscores that imaging surrogates need linkage to symptoms before clinical value is claimed.
Thai researcher contribution
Chulalongkorn orthopedic and spine-innovation teams with a Korean collaborator conducted the randomized trial in Thailand.
Limitations to consider
The trial was small and single-center, with methylprednisolone rather than sham control and unclear blinding. Fibrosis was a secondary result with p=0.047 and possible multiplicity. Twelve months does not establish long-term reoperation effects, and rare harms require larger samples.