Evidence map›Paper›PMID 32789696›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2021

Preoperative epidural steroid injections are not associated with increased rates of infection and dural tear in lumbar spine surgery.

Jayme C B Koltsov, Matthew W Smuck, Todd F Alamin, Kirkham B Wood, Ivan Cheng, Serena S Hu

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Jayme C B KoltsovStanford University School of Medicine, 450 Broadway Street, Pavilion C, 4th Floor, Mail Code 6342, Redwood City, CA, 94063, USA. jcbk@stanford.edu.ORCID 0000-0001-8145-3308
Matthew W SmuckStanford University School of Medicine, 450 Broadway Street, Pavilion C, 4th Floor, Mail Code 6342, Redwood City, CA, 94063, USA.
Todd F AlaminStanford University School of Medicine, 450 Broadway Street, Pavilion C, 4th Floor, Mail Code 6342, Redwood City, CA, 94063, USA.
Kirkham B WoodStanford University School of Medicine, 450 Broadway Street, Pavilion C, 4th Floor, Mail Code 6342, Redwood City, CA, 94063, USA.
Ivan ChengStanford University School of Medicine, 450 Broadway Street, Pavilion C, 4th Floor, Mail Code 6342, Redwood City, CA, 94063, USA.
Serena S HuStanford University School of Medicine, 450 Broadway Street, Pavilion C, 4th Floor, Mail Code 6342, Redwood City, CA, 94063, USA.
Stanford University · US

Funding

Spectrum Stanford Center for clinical and Translational Research and EducationUL1TR001085 · NCATS · STANFORD UNIVERSITY · PI CULLEN, MARK RICHARD, GREENBERG, HARRY BERNARD · 2013 to 2017
$37.1M
6 · The paper itself

Abstract

purposeThe study objectives were to use a large national claims data resource to examine rates of preoperative epidural steroid injections (ESI) in lumbar spine surgery and determine whether preoperative ESI or the timing of preoperative ESI is associated with rates of postoperative complications and reoperations.

methodsA retrospective longitudinal analysis of patients undergoing lumbar spine surgery for disc herniation and/or spinal stenosis was undertaken using the MarketScan® databases from 2007-2015. Propensity-score matched cohorts were constructed to compare rates of complications and reoperations in patients with and without preoperative ESI.

resultsWithin the year prior to surgery, 120,898 (46.4%) patients had a lumber ESI. The median time between ESI and surgery was 10 weeks. 23.1% of patients having preoperative ESI had more than one level injected, and 66.5% had more than one preoperative ESI treatment. Patients with chronic pain were considerably more likely to have an ESI prior to their surgery [OR 1.62 (1.54, 1.69), p < 0.001]. Patients having preoperative ESI within in close proximity to surgery did not have increased rates of infection, dural tear, neurological complications, or surgical complications; however, they did experience higher rates of reoperations and readmissions than those with no preoperative ESI (p < 0.001).

conclusionHalf of patients undergoing lumbar spine surgery for stenosis and/or herniation had a preoperative ESI. These were not associated with an increased risk for postoperative complications, even when the ESI was given in close proximity to surgery. Patients with preoperative ESI were more likely to have readmissions and reoperations following surgery.

Indexed as

Spinal StenosisHumansInjections, EpiduralLumbar VertebraeNeurosurgical ProceduresRetrospective StudiesSteroidsSteroidsDural tearEpidural steroid injectionInfectionLumbar surgeryPostoperative complicationsPreoperative injection

Identifiers

PMID32789696
OpenAlexW3048506195

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.