New Delhi: Asthma patients who use long-term inhalers and undergo spine surgery may face a higher risk of requiring repeat operations, according to a new international study. The research, led by Johns Hopkins University in collaboration with AIIMS Delhi and other institutions, found that patients on regular inhaled steroids were over three times more likely to need another surgery after spinal fusion compared to those not using these medications.
Key findings of the study
The study revealed that asthma itself did not increase the risk of repeat surgery. Instead, the long-term use of steroid-based inhalers appeared to be the critical factor affecting outcomes after spinal fusion. Patients who were not on these medicines had results similar to those without asthma. While the impact of long-term oral steroids on bone healing is well known, the effects of inhaled steroids on spine surgery outcomes have been less clear until now.
Mechanism behind the risk
Doctors explained that spinal fusion surgery depends on proper bone healing. Long-term steroid use can weaken bones and slow healing, increasing the chances of complications or repeat procedures. Professor Bhavuk Garg of AIIMS stated that even inhaled steroids, long considered safe, may subtly compromise bone health and spinal fusion outcomes. He emphasized that in a country like India, where both asthma and osteoporosis are under-recognized, this calls for careful pre-operative evaluation and optimization. The findings are particularly relevant given rising air pollution and a growing elderly population.
Additional complications
The study also found higher rates of problems such as poor bone fusion and implant-related issues among patients using inhalers, pointing to possible underlying bone weakness. However, researchers stressed that the findings show a link, not a direct cause.
Implications for patients and doctors
Experts said the findings are important for patients planning spine surgery, suggesting the need to assess bone health and carefully manage treatment in those on long-term inhalers. Inhaled steroids remain essential for asthma control, but doctors say patients should continue them under medical guidance, especially if surgery is planned. The study underscores the importance of identifying at-risk patients early and optimizing bone health before surgery to improve outcomes.
