HCPLive Network

Epidural Steroid Shot Has Adverse Effect on Bone Density

MONDAY, Dec. 3 (HealthDay News) -- For postmenopausal women, treatment of the pain associated with radiculopathy with epidural steroid injection (ESI) has an adverse effect on bone mineral density (BMD), according to a study published in the Dec. 1 issue of Spine.

Ahmad Al-Shoha, M.B.B.S., of the Summa Health System in Akron, Ohio, and colleagues conducted a prospective, observational study involving 28 postmenopausal women experiencing pain associated with radiculopathy who elected to have an L4-L5 ESI. BMD was measured at baseline (pre-injection) and at three and six months post-injection.

Compared with baseline, at six months the researchers observed a significant decrease of 0.018 g/cm² in hip BMD, compared with a 0.003 g/cm² decline in an age-matched control population. There was a significant 2.33 U/L increase in bone-specific alkaline phosphatase, a marker of bone turnover, from three to six months, while the increase in serum C-telopeptide of collagen I was not significant.

"Our findings show that epidural administration of corticosteroids has a deleterious effect on bone, which should be considered when contemplating treatment options for radiculopathy," the authors write. "The resulting decrease in BMD, while slight, suggests that ESIs should be used with caution in those at a risk for fracture."

One or more authors disclosed financial ties to a commercial entity related directly or indirectly to the study.

Full Text (subscription or payment may be required)

Copyright © 2012 HealthDay. All rights reserved.

Further Reading
Magnetic resonance imaging does not improve outcomes for patients with sciatica who are candidates for epidural steroid injection and has only a minor effect on decision making regarding treatment for these patients, researchers have found.
Between 2000 and 2008, there was a nearly 108 percent increase in the number of Medicare recipients receiving spinal interventional techniques, according to a study published in the Jan. 15 issue of Spine.
Considerable morbidity and mortality resulted from the use of three lots of fungus-contaminated methylprednisolone acetate, recalled by the pharmacy, according to a preliminary report published online Dec. 19 in the New England Journal of Medicine.
Though original results of the five-year Spine Patient Outcomes Research Trial (SPORT) determined surgically-treated spinal stenosis (SpS) patients showed significant advantage in body pain and physical function after two years than their nonsurgically-treated counterparts, a subgroup analysis published in the Feb. 15 issue of Spine found patients who received epidural steroid injections (ESI) in the SPORT study exhibited a worse outcome through four years’ follow-up, regardless of surgical or nonsurgical treatment.
Patients seeing a spine surgeon are most influenced by low back pain intensity when considering whether to proceed with spinal fusion surgery, according to a study published in the Jan. 15 issue of Spine.
Pain beginning at delivery is rarely reported six to 12 months after delivery; and the postpartum period seems to protect from chronic hypersensitivity to peripheral nerve injury in rats, according to two studies published in the January issue of Anesthesiology.
Methylprednisolone injections relieve symptoms of carpal tunnel syndrome in the short term, but most patients still have surgery at one year, according to a study published in the Sept. 3 issue of the Annals of Internal Medicine.
More Reading