Implications of lumbar epidural steroid injections after lumbar surgery.
OBJECTIVE
Assess the relationship between performing lumbar epidural steroid injections (ESIs) after lumbar surgery and workers' compensation claim duration and cost.


METHODS
A multivariate logistic regression was used to determine the association between performing ESI after the first lumbar surgery in 11,394 lost time injury claims filed from 1999 to 2002 followed for 7 years postinjury.


RESULTS
Odds ratio of costs more than $100,000 is 6.49 (95% confidence interval: 4.30 to 9.81) for ever having lumbar ESI after the first lumbar surgery, compared with no spinal procedures, controlling for sex, age, attorney involvement, opioid use, other spinal procedures, and claim duration. Odds ratio of having claim duration longer than 1000 days was 14.73 (95% confidence interval: 7.01 to 30.95).


CONCLUSIONS
Lumbar ESI after the first lumbar surgery was associated with high cost and longer claim duration.
From the Division of Occupational and Environmental Medicine (Drs Tao and Bernacki), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md; Department of Neurology (Dr Lavin), University of Maryland School of Medicine, Baltimore; and Strategic Risk and Strategy Management (Mr Yuspeh), Louisiana Workers' Compensation Corporation, Baton Rouge, La.
Xuguang Grant
XG
Tao
Robert A
RA
Lavin
Larry
L
Yuspeh
Edward J
EJ
Bernacki
D000893:Anti-Inflammatory Agents / Q000191:economics* / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy* / Q000191:economics / Q000209:etiology; D006801:Humans; D007268:Injections, Epidural; D016015:Logistic Models; D008145:Louisiana; D017116:Low Back Pain / Q000188:drug therapy* / Q000191:economics / Q000209:etiology; D008159:Lumbar Vertebrae / Q000601:surgery*; D015999:Multivariate Analysis; D016017:Odds Ratio; D010149:Postoperative Pain / Q000188:drug therapy* / Q000191:economics; D012307:Risk Factors; D013256:Steroids / Q000191:economics* / Q000627:therapeutic use; D013997:Time Factors; D014942:Workers' Compensation / Q000191:economics*
D000893:Anti-Inflammatory Agents; D013256:Steroids