Na Yong Jae, Kim Beom Suk, Kwon Woo-Keun
Department of Physical and Rehabilitation Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si, Republic of Korea.
Department of Neurosurgery, Korea University Guro Hospital, Seoul, Republic of Korea.
Eur Spine J. 2025 Jul 26. doi: 10.1007/s00586-025-09172-6.
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.
虽然腰椎融合手术广泛用于治疗退行性疾病，但术后疼痛管理通常需要额外的干预措施。本研究旨在调查腰椎融合手术后三年内脊柱注射的模式和时间。
该研究分析了韩国健康保险审查与评估服务数据库中的数据，包括2013年至2015年间因退行性脊柱疾病接受腰椎融合手术的82951名患者。对患者的结局进行了三年的跟踪，以评估接受不同注射类型（硬膜外阻滞、内侧支阻滞和小关节阻滞）的比例，包括时间趋势和再次手术率。
融合后三年内，36.1%的患者接受了硬膜外阻滞，12.8%接受了内侧支阻滞，6.2%接受了小关节阻滞。首次注射的平均时间为422±303天。注射率在最初6个月最高（占所有首次注射的29.6%），此后逐渐下降。与未接受注射的患者（4.2-7.5%）相比，接受注射的患者再次手术率更高（15.4-18.9%）。
这项全国性研究表明，融合后脊柱注射的使用率很高，其中硬膜外阻滞占主导。这些发现表明了谨慎选择患者的重要性，并强调了对患者进行全面教育以了解潜在长期结局（包括延长疼痛管理策略）的必要性。
