Epidural Steroid Injections and Osteoporotic Fracture Risk
Prior research has shown a link between glucocorticoids and bone loss related to glucocorticoid-induced osteoporosis, according to researchers at the Kangwon National University Hospital in South Korea. However, the researchers argue that the links between ESIs, bone mineral density (BMD), and risk of vertebral fractures remain unclear.
In a recent study, “Low bone mineral density, but not epidural steroid injection, is associated with fracture in postmenopausal women with low back pain,” the researchers examined these links. The study was published in the November 2012 issue of the journal Pain Physician.
The study authors conducted a retrospective, cross-sectional clinical study at a university pain management center. They examined medical data on postmenopausal women who had an ESI as treatment for low back pain. The study included data on 352 women.
The women were divided into 2 groups: women who did not sustain fractures, and those who did. The researchers also recorded information about the women’s BMD measurements, the site of their fractures, if any, and the various low back pain treatments used.
The results of the study showed that 218 out of the 352 patients included (62%) did not experience fractures, while 134 (38%) did. Patients who sustained fractures were significantly older than those who did not. Additionally, BMD measurements were lower, and the prevalence of osteoporosis was significantly higher, in patients who had fractures. Besides age, height and weight also played an important role in patients’ BMD.
The researchers conclude that their study demonstrates an association between older age and low bone mineral density with risk of osteoporotic fracture in postmenopausal women with low back pain. However, they argue that epidural steroid injections, on their own, were not associated with lower bone mineral density or greater risk of fractures.