Infectious complications of commonly performed spinal injections

Infections after spinal injections are rare but devastating complications. The purpose of this review is to provide an evidence-based assessment of the case report literature to characterize the predisposing epidemiological and clinical features of patients who developed infectious complications after commonly performed spinal injections. All patients received a corticosteroid as part of the injection. The mean time to symptom onset from the last injection was 14 days, during which patients presented with worsening spinal pain and the onset of new neurological symptoms. The most common type of infection was an epidural abscess, while the most frequently cultured organism was Staphylococcus aureus. The presence of an underlying medical illness that adversely impacts immune function could represent a potential risk factor for development of an epidural abscess. Immunocompromised patients should be identified before performing an epidural injection, and antibiotic prophylaxis for S. aureus should be considered.