A study published in Mayo Clinic Proceedings: Innovations, Quality & Outcomes aimed to determine the risk difference and prediction intervals for postoperative infections (POIs) associated with preoperative epidural steroid injections (ESIs) in adults undergoing lumbar or cervical spine surgery. The researchers conducted comprehensive database searches and included 12 studies in their systematic review, with 9 studies 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 a POI, while ESIs within 1-3 months were associated with a 2.31% greater risk. In adults over 65 years, ESIs within 1 or 1-3 months were associated with a 1.3% and 0.6% greater risk, respectively. However, there was no increased risk of POI associated with ESIs within 3 months of cervical spine fusion. The study provides 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 : the highest rated 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 Decompression 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 : the highest rated 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
