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Stony Brook Orthopaedic and Musculoskeletal Journal

Keywords

TriNetX, Infection, pediatric, Steroids, Spine

Abstract

Background: The purpose of this study is to compare recovery and infection outcomes between teenagers and adults who undergo surgery for traumatic spine injuries and the effect of steroid administration. Steroids are often used in traumatic spine injuries to help recovery, however there is a concern that steroid use could increase the risk of infection due to the suppression of the immune system. We examined the impact of postoperative steroid use on recovery rates and infection rates in both age groups.

Methods: A retrospective cohort study was conducted using the TriNetX Research Network, which includes data from over 100 healthcare organizations. Pediatric teenage (13-17 years) and adult (≥18 years) patients who sustained spial injuries between January 2010 and July 2025 were included.  Patients were identified by a documented diagnosis within one week before surgery and matched 1:1 to controls using propensity score matching based on demographics and comorbidities.  Postoperative infection and return-to-operating room rates were assessed within 90 days of the index spine surgery.

Results: Among teenage patients, steroid exposure was not associated with significant differences in postoperative infection rates but was associated with lower rates of reoperation within 90 days of initial spine surgery.  In adults, perioperative steroid use was also not linked to significant changes in infection rates, including intraspinal abscess or osteomyelitis.  Adults who received steroids also were associated with lower rates of reoperation within 90 days of initial spine surgery.

Conclusions: Perioperative steroid use was associated with decreased 90-day reoperation rates for both adults and teenagers.  There were also no significant differences in postoperative infection risk among adults and teenagers.  These findings suggest that steroids may enhance postoperative recovery in both teenagers and adults undergoing surgery for spinal trauma, while maintaining an acceptable safety profile.

Disclosure Statement

The authors declare that they have no conflicts of interest.

Corresponding Author

Brian Lynch, MD

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