Impact of Short-term Perioperative Steroid Administration on Outcomes of 1- and 2-Level Transforaminal Lumbar Interbody Fusion.

IF 2.6 2区 医学 Q2 CLINICAL NEUROLOGY
Spine Pub Date : 2025-03-03 DOI:10.1097/BRS.0000000000005321
Mitsuhiro Nishizawa, Steven D Glassman, Mladen Djurasovic, Charles H Crawford, Jeffrey L Gum, John R Dimar, R Kirk Owens, Leah Y Carreon
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Abstract

Study design: Retrospective observational cohort.

Objective: To assess the impact of short-term perioperative use of systemic steroids on the surgical outcomes of one- to two-level transforaminal lumbar fusion (TLIF), with a primary focus on complications.

Summary of background data: Steroids are commonly used in the perioperative period, including as a standard anesthesia practice and control for postoperative pain. However, the impact of perioperative use of systemic steroids on the surgical outcomes of lumbar fusion surgery remains unclear.

Methods: We retrospectively reviewed 560 patients who underwent one- or two-level TLIF. Complications rates within one year postoperatively were compared between the patients who received perioperative steroids and those who did not. Additionally, the total cumulative steroid dose as prednisolone equivalents was compared between patients with and without complications.

Results: 380 patients (68%) received steroids perioperatively, with a mean prednisolone equivalent dose of 110±341.3 mg. Intraoperative steroids were administered to 359 patients (64%), with a mean dose of 46.6±13.8 mg, while 45 patients (8%) received steroids postoperatively, with a mean dose of 558.1±863.5 mg. There were no significant differences in any complication rates between patients who received steroids perioperatively, postoperatively, or intraoperatively and those who did not, respectively. Patients who experienced complications had lower total cumulative steroid dose compared to those without any complications, and the differences reached to significant in infections (39.9±53.2 mg vs. 77.6±297.0 mg, P=0.015); minor complications (37.2±51.5 mg vs. 79.9±304.2 mg, P=0.005); and nonunion (49.8±78.1 mg vs. 89.1±336.5 mg, P=0.046).

Conclusion: This study found that short-term perioperative use of systemic steroids was not associated with increased complications, and perioperative administration of steroids may have potential protective effects.

围手术期短期类固醇治疗对1节段和2节段经椎间孔腰椎椎间融合术疗效的影响。
研究设计:回顾性观察队列。目的:评估围手术期短期使用全身性类固醇对一至二节段经椎间孔腰椎融合术(TLIF)手术结果的影响,主要关注并发症。背景资料总结:类固醇通常用于围手术期,包括作为标准麻醉和术后疼痛控制。然而,围手术期使用全身性类固醇对腰椎融合术手术结果的影响尚不清楚。方法:我们回顾性分析了560例接受一级或二级TLIF的患者。比较围手术期接受类固醇治疗和未接受类固醇治疗的患者术后一年内的并发症发生率。此外,作为强的松龙当量的总累积类固醇剂量在有和没有并发症的患者之间进行了比较。结果:380例患者(68%)围手术期接受类固醇治疗,平均强的松龙等效剂量为110±341.3 mg。术中使用类固醇药物359例(64%),平均剂量为46.6±13.8 mg;术后使用类固醇药物45例(8%),平均剂量为558.1±863.5 mg。在围手术期、术后和术中分别接受类固醇治疗的患者和未接受类固醇治疗的患者之间,并发症发生率无显著差异。与无并发症的患者相比,出现并发症的患者类固醇总累积剂量较低,感染方面差异达到显著性(39.9±53.2 mg vs. 77.6±297.0 mg, P=0.015);轻微并发症(37.2±51.5 mg vs 79.9±304.2 mg, P=0.005);骨不连(49.8±78.1 mg vs. 89.1±336.5 mg, P=0.046)。结论:本研究发现围手术期短期使用全身类固醇与并发症增加无关,围手术期使用类固醇可能具有潜在的保护作用。
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来源期刊
Spine
Spine 医学-临床神经学
CiteScore
5.90
自引率
6.70%
发文量
361
审稿时长
6.0 months
期刊介绍: Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store. Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
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