Do Preoperative Epidural Steroid Injections Increase the Risk of Postoperative Complications Following Cervical Disc...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Anesthesiology

Background:

• Preoperative epidural steroid injections (ESIs) are common for cervical spine issues.
• Previous research links ESIs to complications after anterior cervical discectomy and fusion.
• The impact of ESIs on outcomes after cervical disc replacement (CDR) remains unclear.

Purpose of the Study:

• To investigate the association between preoperative ESIs and postoperative complications following CDR.
• To evaluate the impact of ESIs on readmissions and reoperation rates after CDR.

Main Methods:

• Retrospective analysis of the PearlDiver Database (2010-2022).
• Patients undergoing CDR were stratified by ESI use within 90 days pre-surgery.
• Propensity-score matching was employed to control for baseline differences; outcomes included 90-day complications, readmissions, and 2-year reoperations.

Main Results:

• ESI group showed significantly higher rates of postoperative urinary tract infections (3.2% vs. 1.6%) and recurrent radiculopathy (63.1% vs. 16.1%).
• Higher rates of revision surgery within 2 years (7.8% vs. 2.4%) and 30-day emergency department visits (6.2% vs. 4.8%) were observed in the ESI group.
• Readmission rates were significantly elevated at 30 days (2.8% vs. 1.1%) and 90 days (9.7% vs. 2.0%) for patients who received preoperative ESIs.

Conclusions:

• Preoperative ESIs administered within 90 days of CDR are associated with increased postoperative complications.
• The use of ESIs prior to CDR correlates with higher rates of readmission and reoperation.
• These findings suggest a need to reconsider the routine use of preoperative ESIs before CDR.