You are viewing AANS Neurosurgeon Volume 26, Number 1, 2017. View our current issue, Volume 26, Number 3, 2017

AANS Neurosurgeon | Volume 26, Number 1, 2017

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Increased Risk of Postoperative Infection When Spinal Fusion Surgery Closely Follows Lumbar Epidural Steroid Injection

Research conducted at the University of Virginia suggests that patients may wish to take a one to three month break from lumbar epidural steroid injections (LESIs) before undergoing lumbar spinal fusion surgery. Why? An increased risk of infection has been identified when LESIs are administered within three months prior to surgery. Lumbar epidural steroid injections (LESIs) are administered to patients with low-back pain and associated leg pain. The injection delivers corticosteroid medications to the epidural space, an area just outside the spinal sac containing the spinal cord and nerve roots. Once there, the medicine’s anti-inflammatory effects reduce nerve root inflammation, local ischemia and the pain resulting from both. LESI is a standard nonsurgical option to treat persistent and severe low-back pain and radicular leg pain (sciatica). LESI treatment is generally considered safe, although sometimes complications, such as infection, nerve damage, or bleeding, can occur. In some cases lumbar spinal fusion surgery must be performed if LESI fails to provide durable pain relief.

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