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European Spine Journal

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01-07-2020 | Original Article

Preoperative lumbar epidural steroid injections administered within 6 weeks of microdiscectomy are associated with increased rates of reoperation

Authors: Sarah Bhattacharjee, Sean Pirkle, Lewis L. Shi, Michael J. Lee

Published in: European Spine Journal | Issue 7/2020

Abstract

Purpose

Lumbar epidural steroid injections (LESIs) are widely utilized for back pain. However, as studies report adverse effects from these injections, defining a safe interval for their use preoperatively is necessary. We investigated the effects of preoperative LESI timing on the rates of recurrent microdiscectomy.

Methods

This study utilized the PearlDiver national insurance claims database. Microdiscectomy patients were stratified by the timing of their most recent LESI prior to surgery into bimonthly cohorts (0–2 months, 2–4 months, 4–6 months). This first cohort was further stratified into biweekly cohorts (0–2 weeks, 2–4 weeks, 4–6 weeks, 6–8 weeks). The 6-month reoperation rate was assessed and compared between each injection cohort and a control group of patients with no injections within 6 months before surgery. Univariate analyses of reoperation were conducted followed by multivariate analyses controlling for risk factors where appropriate.

Results

A total of 12,786 microdiscectomy patients were identified; 1090 (8.52%) received injections within 6 months before surgery. We observed a significant increase in the 6-month reoperation rates in patients who received injections within 6 weeks prior to surgery (odds ratio [OR] 1.900, 1.218–2.963; p = 0.005) compared to control. No other significant differences were observed.

Discussion

In this study, microdiscectomy performed within 6 weeks following LESIs was associated with a higher risk of reoperation, while microdiscectomy performed more than 6 weeks from the most recent LESI demonstrated no such association with increased risk. Further research into the interaction between LESIs and recurrent disk herniation is necessary.

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Title: Preoperative lumbar epidural steroid injections administered within 6 weeks of microdiscectomy are associated with increased rates of reoperation
Authors: Sarah Bhattacharjee
Sean Pirkle
Lewis L. Shi
Michael J. Lee
Publication date: 01-07-2020
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 7/2020
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-020-06410-x

2024 ASCO Annual Meeting

Springer Medicine

Preoperative lumbar epidural steroid injections administered within 6 weeks of microdiscectomy are associated with increased rates of reoperation

Abstract

Purpose

Methods

Results

Discussion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Discussion

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