Infection Following Fusion in Patients Receiving Spinal Injections First — Smoke or Fire?
This study found no difference, but we remain concerned.
What’s the Claim?
A historically controlled but underpowered study using careful matching from an institutional registry suggested no increase in the risk of surgical site infections among patients who had a spinal corticosteroid injection <1 month or 1 to 3 months prior to surgery compared with patients who had no injections before surgery. A higher percentage of those who had injections at those time points had CSF leaks (11% and 7%, respectively) compared to those who had no injections (5%; p = 0.02). The authors claimed a number of other differences that seem likely to be related to spurious significance (making too many statistical tests at the p < 0.05 level), because many of the differences they “found” had little or no biologically plausible connection to injections (such as venous thromboembolism, opioid usage, or pooled odds of complications or readmissions).
