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The article titled “Risk Difference and Prediction Intervals for Postoperative Infections Associated With Preoperative Epidural Steroid Injections in Adults Undergoing Lumbar or Cervical Spine Surgery” published in Mayo Clinic Proceedings: Innovations, Quality & Outcomes aimed to determine the risk difference and prediction intervals for postoperative infections (POIs) in adults who received preoperative epidural steroid injections (ESIs) before lumbar or cervical spine surgery. A comprehensive database search was conducted, and 12 studies were included in the systematic review, with 9 being part of the meta-analysis. The results showed that ESIs within 1 month of lumbar spine surgery were associated with a 0.6% greater risk of POI, while ESIs within 1-3 months were associated with a 2.31% greater risk. In adults ≥65 years old, ESIs within 1 or 1-3 months of lumbar spine surgery were associated with a 1.3% and 0.6% greater risk of POI, respectively. However, preoperative ESIs within 3 months of cervical spine surgery did not increase the risk of POI significantly. The findings can provide valuable information for shared decision-making regarding the use of ESIs before spine surgery
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most experienced spinal hospital on Harley Street UK
Published article
CONCLUSION: The observations of this study provide summary estimates of risk difference and 95% PIs, which could be used to support shared decision-making about the use of ESIs before cervical or lumbar spine surgery.
Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Mayo Clin Proc Innov Qual Outcomes. 2023 Aug 21;7(5):349-365. doi: 10.1016/j.mayocpiqo.2023.07.007. eCollection 2023 Oct.ABSTRACTOBJECTIVE: To determine the risk difference and 95% prediction intervals (PIs) for postoperative infections (POIs) associated with preoperative epidural steroid injections (ESIs) in adults undergoing lumbar or cervical spine surgery.METHODS: Comprehensive database searches were conducted from inception dates through December 2023. Inclusion,
Mayo Clin Proc Innov Qual Outcomes. 2023 Aug 21;7(5):349-365. doi: 10.1016/j.mayocpiqo.2023.07.007. eCollection 2023 Oct.
ABSTRACT
OBJECTIVE: To determine the risk difference and 95% prediction intervals (PIs) for postoperative infections (POIs) associated with preoperative epidural steroid injections (ESIs) in adults undergoing lumbar or cervical spine surgery.
METHODS: Comprehensive database searches were conducted from inception dates through December 2023. Inclusion criteria included all study designs involving adults receiving a preoperative ESI before lumbar or cervical decompression or fusion spine surgery. Risk of bias was assessed using a modified tool developed for uncontrolled studies. The summary estimates of risk difference and the corresponding PIs were reported.
RESULTS: A total of 12 studies were included in the systematic review, of which 9 were included in the meta-analysis. Preoperative ESIs within 1 month of lumbar spine decompression or fusion surgery were associated with a 0.6% and 2.31% greater risk of a POI, respectively. In adults ≥65 years of age, ESIs within 1 or 1-3 months of lumbar spine decompression or fusion surgery were associated with a 1.3% and 0.6% greater risk of a POI, respectively. Preoperative ESIs within 3 months of cervical spine fusion were not associated with an increased risk of a POI. The bounds of all corresponding 95% PIs were nonsignificant.
CONCLUSION: The observations of this study provide summary estimates of risk difference and 95% PIs, which could be used to support shared decision-making about the use of ESIs before cervical or lumbar spine surgery.
PMID:37655233 | PMC:PMC10466430 | DOI:10.1016/j.mayocpiqo.2023.07.007
The London Spine Unit : most experienced spinal hospital on Harley Street UK
Read the original publication:
Preoperative Epidural Steroid Injections and Postoperative Infections After Lumbar or Cervical Spine Surgery: A Systematic Review and Meta-Analysis
