Methylprednisolone 125 mg i.v. 1 day after surgery gave similar early reduction of pain as i.v. ketorolac 30 mg. Less pain than placebo 24 h after methylprednisolone, and lower opioid consumption for 72 h compared with ketorolac and placebo indicate sustained analgesic effects of methylprednisolone.

This study entails a prospective evaluation of lumbar closing wedge osteotomy for correction of thoracolumbar kyphotic deformity in ankylosing spondylitis. Twenty patients with a median age of 52 years (range, 26-70) underwent follow-up at one year. The lumbar closing wedge osteomtomy was stabilised by metallic rods fixed by transpedicular screws. Outcome measures were quality of life (EuroQol), occiput-to-wall distance, pain, fatigue, complications, technical and radiological evaluation. The technical result was good in 16 and fair in four patients; two had neuropraxia. The deformity was reduced an average of 17 degrees (95% confidence interval 15-25 degrees) at one-year follow-up. Pain during activity, pain at night, and fatigue were significantly reduced. EuroQol improved from 0.42 to 0.69 (p = 0.002) and occiput-to-wall distance from 26 to 18 cm (p = 0.005). Functional outcome was improved after lumbar closing wedge osteotomy in ankylosing spondylitis.

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This study shows that in traumatic injury there are generally higher local than systemic expressions of inflammatory mediators, and that the main anti-inflammatory effects of high-dose corticosteroids are suppression of systemic IL-6 and increased expressions of IL-10 and sTNF-R1, both systemically and locally.