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Peer-reviewedCC BY-NC-ND 4.0BMC Musculoskeletal Disorders

Clinical outcomes associated with drug-soaked acellular dermal matrix after biportal endoscopic lumbar surgery: a retrospective comparative study

  • Sub-Ri Park1
  • Namhoo Kim1
  • Hak-Sun Kim2
  • Seong-Hwan Moon2
  • Si-Young Park2
  • Jae-Won Shin2
  • Ji-Won Kwon3
  • Kyung-Soo Suk3
  • Byungho Lee3
  • Jae-Nam Lee3
  • Jin-Oh Park1
  1. 1Department of Orthopedic Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, 10 Gyeonggi-do, Seoul, Gyeonggi-do 16988 Republic of Korea
  2. 2Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, 03722 Republic of Korea
  3. 3Department of Orthopedic Surgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei 13University College of Medicine, Seoul, 06273 Republic of Korea
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Abstract

Purpose: To evaluate the clinical outcomes associated with epidurally applied acellular dermal matrix (ADM) soaked with dexamethasone or fentanyl following biportal endoscopic lumbar surgery (BESS).

Methods: This retrospective comparative study included 90 patients who underwent lumbar decompression or discectomy using BESS. Patients were divided into three groups according to intraoperative epidural management: a control group without ADM, an ADM group soaked with dexamethasone and an ADM group soaked with fentanyl. Postoperative pain scores, IV PCA usage, laboratory inflammatory markers including IL-6, functional outcomes, and postoperative medication use were compared among groups.

Results: Baseline demographic and surgical characteristics were comparable among groups. Both ADM groups demonstrated earlier IV PCA discontinuation and greater residual PCA volume at discontinuation compared with the control group. The fentanyl-soaked ADM group showed greater reductions in postoperative pain scores and a shorter hospital stay. IL-6 levels were significantly lower in the dexamethasone-soaked ADM group on postoperative days 2 and 3. While ODI scores improved similarly across all groups, both ADM groups demonstrated differences in early patient-reported recovery outcomes on SF-36 assessments.

Conclusion: Use of drug-soaked ADM was associated with differences in acute postoperative pain scores, earlier IV PCA discontinuation, greater residual PCA reservoir volume at discontinuation, and improved early patient-reported recovery outcomes during the immediate postoperative period. These findings demonstrate associations between the use of drug-soaked ADM and the observed early postoperative clinical outcomes following biportal endoscopic lumbar surgery. Future prospective multicenter studies with longer follow-up are warranted to validate these findings and further clarify their long-term clinical significance.

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Cite

BibTeXRIS
BibTeX
@article{park2026clinical,
  title = {{Clinical outcomes associated with drug-soaked acellular dermal matrix after biportal endoscopic lumbar surgery: a retrospective comparative study}},
  author = {Sub-Ri Park and Namhoo Kim and Hak-Sun Kim and Seong-Hwan Moon and Si-Young Park and Jae-Won Shin and Ji-Won Kwon and Kyung-Soo Suk and Byungho Lee and Jae-Nam Lee and Jin-Oh Park},
  journal = {BMC Musculoskeletal Disorders},
  year = {2026},
  month = aug,
  doi = {10.1186/s12891-026-10336-8},
  url = {https://doi.org/10.1186/s12891-026-10336-8},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Clinical outcomes associated with drug-soaked acellular dermal matrix after biportal endoscopic lumbar surgery: a retrospective comparative study
AU  - Sub-Ri Park
AU  - Namhoo Kim
AU  - Hak-Sun Kim
AU  - Seong-Hwan Moon
AU  - Si-Young Park
AU  - Jae-Won Shin
AU  - Ji-Won Kwon
AU  - Kyung-Soo Suk
AU  - Byungho Lee
AU  - Jae-Nam Lee
AU  - Jin-Oh Park
PY  - 2026
DA  - 2026/08/07
JO  - BMC Musculoskeletal Disorders
DO  - 10.1186/s12891-026-10336-8
UR  - https://doi.org/10.1186/s12891-026-10336-8
AB  - Purpose: To evaluate the clinical outcomes associated with epidurally applied acellular dermal matrix (ADM) soaked with dexamethasone or fentanyl following biportal endoscopic lumbar surgery (BESS).  Methods: This retrospective comparative study included 90 patients who underwent lumbar decompression or discectomy using BESS. Patients were divided into three groups according to intraoperative epidural management: a control group without ADM, an ADM group soaked with dexamethasone and an ADM group soaked with fentanyl. Postoperative pain scores, IV PCA usage, laboratory inflammatory markers including IL-6, functional outcomes, and postoperative medication use were compared among groups.  Results: Baseline demographic and surgical characteristics were comparable among groups. Both ADM groups demonstrated earlier IV PCA discontinuation and greater residual PCA volume at discontinuation compared with the control group. The fentanyl-soaked ADM group showed greater reductions in postoperative pain scores and a shorter hospital stay. IL-6 levels were significantly lower in the dexamethasone-soaked ADM group on postoperative days 2 and 3. While ODI scores improved similarly across all groups, both ADM groups demonstrated differences in early patient-reported recovery outcomes on SF-36 assessments.  Conclusion: Use of drug-soaked ADM was associated with differences in acute postoperative pain scores, earlier IV PCA discontinuation, greater residual PCA reservoir volume at discontinuation, and improved early patient-reported recovery outcomes during the immediate postoperative period. These findings demonstrate associations between the use of drug-soaked ADM and the observed early postoperative clinical outcomes following biportal endoscopic lumbar surgery. Future prospective multicenter studies with longer follow-up are warranted to validate these findings and further clarify their long-term clinical significance.
SN  - 1471-2474
ER  -