Efficacy of local Dexamethasone used in Operation Area after Lumbar Microdiscectomy on postoperative infection

TL;DR

Using dexamethasone during lumbar microdiscectomy may reduce the risk of superficial wound infections, though the effect was not statistically significant.

Contribution

This study explores the effect of local dexamethasone on postoperative infection rates after lumbar microdiscectomy.

Findings

Patients who received local dexamethasone had no superficial wound infections, while 11 in the non-dexamethasone group did.

The local infection rate was significantly higher in the non-dexamethasone group (p < 0.05).

No deep infections were observed in either group.

Abstract

Postoperative wound infection, although relatively uncommon, remains a significant complication of spinal surgery. Preventive strategies must therefore be rigorously implemented before, during and after surgery. While local steroid administration is frequently employed during lumbar microdiscectomy to reduce neural edema, limited evidence exists regarding its effects on infection rates. This study aimed to evaluate the impact of locally applied dexamethasone in the surgical site on the incidence of postoperative infection.

This retrospective observational study was conducted between January 2020 to December 2022 at the Neurosurgery Departments of Van Yüzüncü Yıl University Medical School. A total of 200 patients (89 females, 111 males) who underwent lumbar microdiscectomy were included. Patients were divided into two groups: those who received local dexamethasone (8 mg) applied to the surgical site (n = 54) and those who did not (n = 146). No systemic steroids were used in either group.

In the dexamethasone group, no patients developed superficial wound infection, whereas 11 patients in the non-dexamethasone group did. No deep infection was observed in either group. Although the reduction in infection was not statistically significant, the local infection rate was significantly higher in the non-dexamethasone group (p < 0.05).

Local administration of dexamethasone following lumbar microdiscectomy was associated with a lower rate of superficial wound infection compared with no dexamethasone use. Postoperative infection remains an important clinical concern in spinal surgery, and careful attention to perioperative preventive measures is warranted.

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