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Updated: Aug 6, 2026
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Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
Preoperative Epidural Steroid Injections in Posterior Cervical Fusion: Elevated Risks of Pseudarthrosis and
Sri Tummala1,2, David Gibbs1, Joseph Chavarria1
1Department of Orthopedic Surgery, Baylor University Medical.
Clinical Spine Surgery
|July 20, 2026
Summary
Preoperative epidural steroid injections (ESIs) did not increase short-term complications for posterior cervical fusion (PCF) patients. However, ESIs were linked to higher risks of pseudarthrosis and reoperation long-term.
Area of Science:
- Spine Surgery
- Pain Management
- Orthopedics
Background:
- Epidural steroid injections (ESIs) are frequently used for cervical radiculopathy.
- Concerns exist regarding ESI's impact on postoperative outcomes after spinal fusion.
- Potential adverse effects include infection and compromised fusion integrity.
Purpose of the Study:
- To assess the influence of preoperative ESIs on postoperative complications in patients undergoing posterior cervical fusion (PCF).
- Evaluate short-term and long-term outcomes associated with ESI use before PCF.
Main Methods:
- Retrospective cohort study of 63,132 patients undergoing PCF (2015-2022).
- Comparison of patients receiving ESIs within 30 days before surgery versus those who did not.
- Propensity score matching used to balance demographic and comorbidity factors.
- Outcomes included infection, ED visits, readmissions, pseudarthrosis, and reoperation rates.
Main Results:
- No significant differences in short-term infection, ED visits, or readmissions between ESI and non-ESI cohorts.
- The ESI cohort showed significantly higher rates of pseudarthrosis at 1 and 3 years post-surgery.
- A trend towards increased 3-year reoperation rates was observed in the ESI group.
Conclusions:
- Preoperative ESIs do not elevate short-term complications or healthcare utilization after PCF.
- ESI use is associated with increased risks of pseudarthrosis and potentially higher long-term reoperation rates.
- Surgeons should weigh these long-term risks when considering ESIs before PCF.
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