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Complications After Lumbar Spine Epidural Steroid Injections: Incidence and Risk Factors.
Luca M Valdivia1, Mayuri Jain1,2,3, Olgerta Mucollari1
1Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Global Spine Journal
|January 20, 2026
Summary
Lumbar epidural steroid injections (LESIs) have a low risk of complications, occurring in 2.5% within 7 days and 8.8% within 30 days. Older age and certain medical conditions increase this risk.
Area of Science:
- Pain Management
- Neurosurgery
- Radiology
Background:
- Lumbar epidural steroid injections (LESIs) are a common treatment for lumbar spine degenerative conditions.
- Understanding the incidence and risk factors of LESI complications is crucial for patient safety.
Purpose of the Study:
- To determine the incidence of complications following lumbar epidural steroid injections (LESIs).
- To identify patient-specific risk factors associated with LESI-related complications.
Main Methods:
- Retrospective study analyzing 722,366 LESIs in patients aged 18+ from 2014-2021.
- Complications were categorized as overall, procedural, or medical.
- Generalized estimating equations logistic regression identified risk factors at 7 and 30 days post-injection.
Main Results:
- Overall complication rates were 2.5% within 7 days and 8.8% within 30 days.
- Transforaminal approach (54.0%) was more common than interlaminar (45.0%).
- Risk factors included older age, heart failure, renal dysfunction, neurological deficits, and anticoagulant use.
Conclusions:
- LESIs carry a rare but significant risk of complications up to 30 days post-procedure.
- Patient factors like advanced age and comorbidities are associated with increased complication risk.
- Further research may refine patient selection and procedural protocols.
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