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Implications of Lumbar Epidural Steroid Injections After Lumbar Surgery

Tao, Xuguang (Grant) MD, PhD; Lavin, Robert A. MD, MS; Yuspeh, Larry BA; Bernacki, Edward J. MD, MPH

Journal of Occupational & Environmental Medicine: February 2014 - Volume 56 - Issue 2 - p 195–203
doi: 10.1097/JOM.0000000000000076
Original Articles

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).

Conclusion: 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.

Address correspondence to: Edward J. Bernacki, MD, MPH, Division of Occupational and Environmental Medicine, Department of Medicine, Johns Hopkins University School of Medicine, 600 N Wolfe St, Billings Administration 129, Baltimore, MD 21287 (bernacki@jhmi.edu).

The Louisiana Workers' Compensation Corporation provided the data set for the study, and the Johns Hopkins University performed the statistical analyses of the supplied data.

There are no conflicts of interest.

Copyright © 2014 by the American College of Occupational and Environmental Medicine