Epidural steroids and elective surgical risk

[Grundel76]

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How soon can someone be operated on after an epidural steroid injection?

I am assuming the steroid dose has to do something to healing and infection. Is there an appropriate time period to wait after an ESI before doing an elective surgery?

 

[PMR 4 MSK]

Depends on the surgery/location and where/when the injection performed and with how much steroid. In general, most surgeries would be safe in proximity to the injection, but surgeon's opinions vary greatly. Whenever this is an issue, I ask the surgeon directly, most are ok with them. I'm sure many of us have done them within days of planned spine surgery, just to buy them time.

 

[Kwijibo]

You can pretty much inject someone immediately after a surgery, if you and the surgeon would want it to be done. Very often after surgery patients are left with radics or have new radics and new pain. The first thing these patients get is IV steroids while they are still in the hospital, or PO if they are already d/c'd.
My opinion is that many times there are less side effects/risks to perform a transforaminal epidural steroid injection on someone with minimal risk factors and more benefit than it is to give them a steroid dose pack.
The main factor is that you and the surgeon are on the same page as far as post operative care.

 

[mille125]

You can pretty much inject someone immediately after a surgery, if you and the surgeon would want it to be done. Very often after surgery patients are left with radics or have new radics and new pain. The first thing these patients get is IV steroids while they are still in the hospital, or PO if they are already d/c'd.
My opinion is that many times there are less side effects/risks to perform a transforaminal epidural steroid injection on someone with minimal risk factors and more benefit than it is to give them a steroid dose pack.
The main factor is that you and the surgeon are on the same page as far as post operative care.

I think that she is asking about doing an injection BEFORE surgery. Specifically she is asking about risk of wound infection because of steroid.....

 

[mille125]

I am on the conservative side here. If I know that someone is having a surgery in the next 4 weeks (especially orthopedic surgery), I always call the surgeon concerning the risks. I now know where many of them stand (some dont care and some dont want steroids within 3 months before surgery). I feel that it is better to ask than to be implicated as contributing to a post op infection or impaired wound/bone healing. I am sure many of the other responders may not agree with this.

 

[Kwijibo]

I won't inject if patient within 2-3 weeks of surgery unless severe pain. I read the post wrong. If the patient is pain then they should consider delaying their surgery anyways.