Patterns of spinal injections following lumbar fusion surgery: a nationwide cohort study with 3-year follow-up.

Abstract

While lumbar fusion surgery is widely performed for degenerative conditions, postoperative pain management often requires additional interventions. This study aimed to investigate the patterns and timing of spinal injections within three years after lumbar fusion surgery. The study analyzed data from the Korean Health Insurance Review & Assessment Service database, including 82,951 patients who underwent lumbar fusion surgery between 2013 and 2015 for degenerative spinal conditions. Patient outcomes were tracked for three years to assess the proportion receiving different injection types (epidural blocks, medial branch blocks, and facet joint blocks), including temporal trends and reoperation rates. Within three years post-fusion, 36.1% received epidural blocks, 12.8% received medial branch blocks, and 6.2% received facet joint blocks. The mean time to first injection was 422 ± 303 days. Injection rates were highest in the first 6 months (29.6% of all first injections), gradually declining thereafter. Patients receiving injections showed higher reoperation rates (15.4-18.9%) compared to those without injections (4.2-7.5%). This nationwide study reveals substantial utilization of spinal injections post-fusion, with epidural blocks being predominant. These findings suggest the importance of careful patient selection and underscore the need for comprehensive patient education regarding potential long-term outcomes, including extended pain management strategies.