scholarly journals Changes in Bone Mineral Density in Postmenopausal Women Treated with Epidural Steroid Injections for Lower Back Pain

2012 ◽  
Vol 3;15 (3;5) ◽  
pp. 229-236
Author(s):  
Byeong-mun Hwang
Keyword(s):  
Bone Mineral Density ◽  
Back Pain ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Lower Back Pain ◽  
Mineral Density ◽  
Epidural Steroid Injections ◽  
Lower Back ◽  
One Year ◽  
Epidural Steroid

Background: Therapy with corticosteroids often results in bone loss and corticosteroid-induced osteoporosis. In previous studies, bone mineral density (BMD) has been examined after administration of relatively high oral doses of corticosteroids. However, practitioners use comparatively lower doses of corticosteroids for epidural steroid injections (ESI). The interactions and relationships between BMD and ESI remain to be determined. Objective: The aim of this study was to explore the relationship between BMD and ESI in postmenopausal women treated for lower back pain. Study design: This study was a retrospective evaluation. Methods: We reviewed the medical records of postmenopausal women with lower back pain who were treated with or without ESI. BMD was measured before treatment and one year after treatment in the lumbar spine, femoral neck, and total femur. A total of 90 postmenopausal women were divided into 2 groups. Group 1 patients received medications without ESI; Group 2 patients received ESI more than 4 times, with a cumulative administered triamcinolone dose of > 120 mg. Results: Decreased BMD was observed in patients treated with ESI. However, no significant difference was observed between or within the groups in terms of mean percentage change from baseline BMD. Limitations: First, this study is limited by the fact that it was retrospective. Second, our study did not consider the use of ESI with high-dose corticosteroids. Third, our study did not include any long-term assessments of the effects of ESI on BMD. Conclusions: These data suggest that ESI using triamcinolone (over 200 mg) for a period of one year will have a negative effect on BMD in postmenopausal women treated for lower back pain. However, ESI therapy using a maximum cumulative triamcinolone dose of 200 mg in one year would be a safe treatment method with no significant impact on BMD. Key words: bone mineral density, corticosteroid, epidural steroid injection, lower back pain, postmenopausal women, triamcinolone.

scholarly journals Low Bone Mineral Density, But Not Epidural Steroid Injection, Is Associated with Fracture in Postmenopausal Women with Low Back Pain

2012 ◽  
Vol 6;15 (6;12) ◽  
pp. 441-449
Author(s):  
Byeongmun Hwang
Keyword(s):  
Bone Mineral Density ◽  
Low Back Pain ◽  
Back Pain ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Low Back ◽  
Mineral Density ◽  
Epidural Steroid

Background: Therapy with glucocorticoids often results in bone loss and glucocorticoidinduced osteoporosis. However, the relationship between epidural steroid injection (ESI), bone mineral density (BMD), and vertebral fracture remains to be determined. Objective: To establish a relationship between ESI, BMD, and vertebral fracture in postmenopausal women with low back pain. Study Design: This study was a retrospective, nonblinded, cross-sectional clinical study. Setting: University-based pain management center. Methods: We reviewed the medical records of postmenopausal women with low back pain who were treated with ESI. A total of 352 postmenopausal women were divided into 2 groups. Group 1 consisted of patients without fracture and Group 2 consisted of those with fractures. The results of BMD measurements, as well as any fragility fractures, the anatomical site involved, and the treatment administered, were also recorded. BMD was measured in the lumbar spine, femoral neck, and total femur after the treatment. Results: Of the 352 patients, 218 (62%) had no fractures while 134 (38%) sustained a fracture. The age was significantly higher among patients who sustained fractures, and BMD at the lumbar spine, total femur, and femoral neck regions was significantly lower among patients who sustained fractures. In each region, the prevalence of osteoporosis was significantly higher in patients with fracture than in patients without fracture (all P < 0.05). Age, height, and weight were associated with low BMD. However, our study showed no consistent correlation between BMD and the mean number of ESIs, mean total dose of glucocorticoids, or mean duration of ESIs. Limitations: First, this study is limited by the fact that it was retrospective. Second, the number of cases receiving very frequent, high-dose glucocorticoid injections was very small. Conclusions: Older age and lower BMD were associated with osteoporotic fracture in postmenopausal women treated for low back pain with ESI. The ESIs were not associated with low BMD or fracture. Key words: Bone mineral density, epidural steroid injection, fracture, glucocorticoids, low back pain, postmenopause.

scholarly journals Bone mineral density, body mass index, postmenopausal period and outcomes of low back pain treatment in Korean postmenopausal women

2010 ◽  
Vol 19 (11) ◽  
pp. 1942-1947 ◽  
Author(s):  
Jongbae J. Park ◽  
Joonshik Shin ◽  
Yousuk Youn ◽  
Catherine Champagne ◽  
Eunseok Jin ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Body Mass Index ◽  
Low Back Pain ◽  
Back Pain ◽  
Postmenopausal Women ◽  
Body Mass ◽  
Bone Mineral ◽  
Pain Treatment ◽  
Low Back ◽  
Mineral Density

Effect of Epidural Steroid Injection on Bone Mineral Density and Markers of Bone Turnover in Postmenopausal Women

Spine ◽  
2012 ◽  
Vol 37 (25) ◽  
pp. E1567-E1571 ◽  
Author(s):  
Ahmad Al-Shoha ◽  
D. Sudhaker Rao ◽  
Jennifer Schilling ◽  
Edward Peterson ◽  
Shlomo Mandel
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Mineral Density ◽  
Markers Of Bone Turnover ◽  
Epidural Steroid

scholarly journals Effect of Lumbar Epidural Steroid Injections on Osteoporotic Fracture and Bone Mineral Density in Elderly Women with Diabetes Mellitus

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Minsoo Kim ◽  
Jiwon Bak ◽  
Sejin Kim ◽  
Hee-Jeong Son ◽  
Seong-Sik Kang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Elderly Women ◽  
Osteoporotic Fractures ◽  
Mineral Density ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
The Mean ◽  
Epidural Steroid

The incidence of osteoporosis and diabetes mellitus (DM) is known to increase with aging. DM is associated with osteoporotic fractures and decreased bone mineral metabolism. However, no studies have compared the effects of DM on the changes in bone mineral density (BMD) and osteoporotic fracture after epidural steroid injections (ESIs). The present study aimed to analyze the relationship between ESI and BMD changes in elderly women with and without DM. The medical records of elderly women who underwent ESI were retrospectively analyzed. All patients had radiographic and BMD assessments performed before and after receiving lumbar ESIs. A total of 172 patients were divided into two groups according to the presence of DM. The duration of BMD monitoring was 16.1 and 16.8 months in the non-DM and DM groups, respectively. The mean total number of ESIs was 3.4 and 3.2, and the mean cumulative administered dose of glucocorticoids (dexamethasone) was 17 and 16 mg in the non-DM and DM groups, respectively. There were no significant differences between baseline and posttreatment BMD in the lumbar spine, total femur, and femoral neck region in either group. The incidence of osteoporotic fractures at the hip joint and thoracolumbar spine was not significantly different in both groups. ESIs could be used without concerns regarding osteoporosis and fractures in elderly women with DM if low doses of glucocorticoids are used.

Sign in / Sign up

Export Citation Format

Share Document