Bone fracture risk increases per epidural steroid injection, study finds

Steroids and strength have long been associated with one another. But pumping up doesn’t necessarily mean fortification for all parts of the body, a new Henry Ford Hospital study finds.

A research team led by Shlomo Mandel, MD, a Henry Ford orthopedic physician, may have stumbled upon a spine-tingling truth about the after-effects of epidural steroid injections — that patients given such treatment are at an increased risk for bone fracture in the spinal region. Moreover, with each injection, a patient’s fracture susceptibility spikes 29 percent.

"For a patient population already at risk for bone fractures, steroid injections carry a greater risk than previously thought and actually pose a hazard to the bone," said Mandel in a news release.

A retrospective study established parameters for the demographics at risk: “Researchers compared data of 6,000 patients treated for back pain between 2007 and 2010 — 3,000 patients who received at least one steroid injection and 3,000 patients who did not receive injection,” a Henry Ford Hospital description reads. “The average age of patients was 66 years, and 3,840 were women and 2,160 were men. Researchers also analyzed the incidence of bone fractures in each group. Using the survival analysis technique, researchers found that the number of steroid injections is linked with an increased likelihood of fracture.”

Additional statistics find that 40 percent of women aged 80 or older have suffered from bone fractures in the spine; an estimated 750,000 patients with osteoporosis also report experience with a break of that nature.

As such, Mandel insisted that physicians make it a priority to inform patients about these risks of epidural steroid treatment, whether osteoporosis prone or otherwise. Although epidural steroid injections are helpful when controlling back pain after physical therapy and anti-inflammatory drugs have failed, Mandel countered that patients still need to be informed about the diminishment of bone quality that can often accompany said alleviants.

The study was presented at the North American Spine Society event in Dallas and was funded by Henry Ford Hospital.


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