Medscape epidural article

[Dr. Ice]

Epidural Steroid Injections Linked to Risk for Post-Op Infection

Patients who receive lumbar epidural steroid injections and go on to have lumbar spine decompressive surgery within 6 months are at heightened risk of infection, new research shows.

www.medscape.com

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[SSdoc33]

i saw this.

mirrors the ortho literature for hip and knee replacements and steroid injections

 

[Ducttape]

retrospective review of studies. more of a metaanalysis, so subject to bias.

should prompt someone to do a prospective blinded study to see if sham injections actually also increase risk of infection.

 

[SSdoc33]

retrospective review of studies. more of a metaanalysis, so subject to bias.

should prompt someone to do a prospective blinded study to see if sham injections actually also increase risk of infection.

seems like that wouldnt pass an IRB

 

[Orin]

But perioperative dexamethasone right around surgery doesn't do diddly? All that Dex 4-8 mg for PONV treatment must not matter.

Still, I'm happy for the surgeon to wait a little longer in case the surgery isn't indicated.

 

[SSdoc33]

But perioperative dexamethasone right around surgery doesn't do diddly? All that Dex 4-8 mg for PONV treatment must not matter.

Still, I'm happy for the surgeon to wait a little longer in case the surgery isn't indicated.

this will give them a reason to not refer for an ESI before a lami, discectomy, or fusion

 

[Orin]

this will give them a reason to not refer for an ESI before a lami, discectomy, or fusion

Oh no, surgeons would never want to jump straight to surgery for a non-indicated and irreversible surgery that could be treat conservatively.

 

[Ducttape]

But perioperative dexamethasone right around surgery doesn't do diddly? All that Dex 4-8 mg for PONV treatment must not matter.

Still, I'm happy for the surgeon to wait a little longer in case the surgery isn't indicated.

yes maybe it is the local application of steroids that increases infection rate.

hence the need to really study it

 

[bedrock]

retrospective review of studies. more of a metaanalysis, so subject to bias.

should prompt someone to do a prospective blinded study to see if sham injections actually also increase risk of infection.

Exactly. a retrospective meta analysis doesn’t mean anything except an extra publication for the authors.