Scientific Paper: Patterns of Spinal Injections Following Lumbar Fusion Surgery: A Nationwide Cohort Study with 3-year Follow-up

Objectives
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.
Design
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.
Results
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%).
Conclusions
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.
Research Study with Best Paper Award Abstract
Abstract
Purpose Lumbar fusion surgery is widely performed for degenerative spinal conditions, yet a considerable number of patients continue to require postoperative pain control. This study aimed to evaluate nationwide patterns and timing of spinal injections within three years after lumbar fusion.

Methods We analyzed 82,951 patients from the Korean Health Insurance Review & Assessment Service database who underwent lumbar fusion between 2013 and 2015. The proportions, types, and timing of postoperative injections—epidural blocks, medial branch blocks, and facet joint blocks—were assessed, along with reoperation rates.

Results Over three years, 36.1% of patients received epidural blocks, 12.8% medial branch blocks, and 6.2% facet joint blocks. The mean time to first injection was 422 ± 303 days, with nearly one-third (29.6%) occurring within the first six months after surgery. Patients who underwent any spinal injection demonstrated higher reoperation rates (15.4–18.9%) compared with those who did not receive injections (4.2–7.5%).

Conclusions This nationwide analysis reveals substantial postoperative use of spinal injections after lumbar fusion, with epidural blocks being most common. These findings underscore the importance of appropriate surgical candidate selection and emphasize the need for comprehensive patient counseling regarding potential long-term outcomes and pain-management strategies.