5 key findings on preoperative epidural injections: Do they increase spinal fusion complications?

Written by Laura Dyrda | May 15, 2017 | Print  |

A new study published in the Journal of Neurosurgery: Spine examines how preoperative epidural injections affect postoperative infection rates for lumbar spinal fusion patients.

The study authors conducted a retrospective analysis of a nationwide insurance database of patient records. The study patients included those who received lumbar spinal fusions one month after lumbar epidural steroid injections, those who had fusions one to three months after the injections and patients who underwent fusion three to six months after injections.

 

The study authors found:

 

1. Overall infection rate at three months after surgery was 1.6 percent.

 

2. When the injection occurred within one to three months of surgery, the infection risk increased.

 

3. Among patients who underwent lumbar fusion three or more months after the injections, the infection rate was similar to the control group.

 

4. The study authors concluded, "Lumbar spinal fusion performed within three months after [lumbar epidural steroid injection] may be associated with increased rate of postoperative infection. This association was not found when lumbar fusion was performed more than three months after [lumbar epidural steroid injection]."

 

5. The complications detected include:

 

• Vasovagal reaction
• Interrupted procedure from intravascular flow
• Pain exacerbation
• Injection site soreness
• Headache
• Facial flushing/sweating
• Insomnia

 

More articles on spine surgery:
Bullish on spin: 5 surgeons on why they recommend the specialty for young physicians
5 things to know about the cost of dural tears in spine surgery
15 things to know about lateral spine surgery

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