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). CONCLUSION: Lumbar ESI after the first lumbar surgery was associated with high cost and longer claim duration.