In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves discuss the impact of epidural steroid injections on bone mineral density / risk of osteoporosis / fracture risk.  

there is conflicting research/data regarding epidural steroid injections and the impact on bone mineral density and fracture risk.  We know that steroids have the potential to have an impact on osteoblast and osteoclast activity, and consequently bone mineral density; however, the exact steroid, the exact dose, the method of delivery, and the patient's response (including possible increase in function/activity/weight bearing exercise) all need to be taken into careful consideration.  

Listen as the doctors discuss some of the available literature, as well as their clinical experience regarding this high yield, practical, and important topic.

 

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This podcast is for information and educational purposes only, it is not meant to be medical advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.

References:

1. Bicket MC, Chakravarthy K, Chang D, Cohen SP. Epidural steroid injections: an updated review on recent trends in safety and complications. Pain Manag. 2015;5(2):129-146.

2. Carreon L, Ong K, Lau E, Kurtz S, Glassman S. Risk of osteoporotic fracture after steroid injections in Medicare patients. The American Journal of Orthopedics. 2017.

3. Mandel S, Schilling J, Peterson E, Rao DS, Sanders W. A retrospective analysis of vertebral body fractures following epidural steroid injections. J Bone Joint Surg Am. 2013;95(11):961-964.