ArticleSpine surgery and related research2026
Chronic Corticosteroid Use Is Associated with Increased Postoperative Complications Following Lumbar Microdiscectomy.
Article in Spine surgery and related research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Introduction: Lumbar microdiscectomy (MLD) is a safe and effective treatment for lumbar disc herniation with low complication rates. However, short-term perioperative complications remain a concern for at-risk patients. Chronic corticosteroid use has been linked to impaired healing and infection in other spinal procedures, yet its impact in MLD remains poorly defined. This study aimed to evaluate the association between chronic corticosteroid use and 30-day complications following elective lumbar MLD. Methods: A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2016 to 2023. Data were collected from adult patients (≥18 years) undergoing microdiscectomy. Patients with fusion procedures or systemic illnesses were excluded. Corticosteroid use was defined according to the NSQIP variable as systemic use within 30 days prior to surgery. A 3:1 nearest-neighbor propensity score matching was performed on key covariates. Multivariable logistic regression was adjusted for race, ethnicity, operative year, and inpatient status. Results: Of 64,380 eligible patients, 2,439 (3.8%) used chronic steroids. Post-matching yielded a cohort of 9,648 patients with well-balanced characteristics. Chronic steroid users had significantly higher odds of 30-day readmission (odds ratio [OR]=1.41; 95% confidence interval [CI]: 1.12-1.77; p=0.003), pneumonia (OR=2.21; 95% CI: 1.08-4.44; p=0.026), deep vein thrombosis (OR=2.04; 95% CI: 1.00-4.08; p=0.046), and sepsis (OR=3.18; 95% CI: 1.60-6.37; p<0.001). Operative time, transfusion rates, and length of stay were similar. Most patients were discharged home, with no differences in disposition between groups. Conclusions: Chronic corticosteroid use is independently associated with increased risks of postoperative sepsis, deep vein thrombosis, pneumonia, and readmission following lumbar microdiscectomy. These findings highlight the importance of perioperative risk stratification and surveillance in this subgroup. Surgeons should consider proactive risk mitigation strategies, such as perioperative infection prophylaxis, pulmonary hygiene, and enhanced thromboprophylaxis, when managing these patients. Further prospective studies are warranted to enhance outcomes in this population.
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