The Journal of Bone and Joint Surgery, one of the leading orthopedic journals, has published this recent article on the risk of vertebral compression fractures
http://www.ncbi.nlm.nih.gov/pubmed/23780532
First, this is a well designed retrospective study. All retrospective studies have some limitations because of some biases that can affect reporting, so that must be kept in mind. The sample pool was a total of 6000 patients out of a database of 50,345, which is a large study.
The looked at 3000 patients who has lumbar epidural steroid injections, and compared these patients to 3000 with low back pain who did not have an epidural steroid injection.
No significant difference was found between the two groups in terms of their baseline characteristics. However, the risk of compression fractures did increase with additional injections.
Bottom line: What does this mean for our patients?
- Spine injections can be a helpful to manage patients with spine conditions, and we perform these injections with guidance (either fluoroscopy or ultrasound) to minimize the need for multiple injections
- One of the risks with any type of corticosteroid injection ("cortisone shots") is that it can weaken bone, including possibly causing a compression fracture
- The risk of compression fractures did increase when patients had multiple injections
- Because of this risk, the physicians as Lake Washington Sports & Spine take care to work with the patient to make sure they understand the risks associated with any decision to have an injection
- We pride ourselves on trying to minimize the total number of injectons the patient needs. It is common for patients to be offered a "series of three" injections, in hopes that one injection may work. That is not our general approach. Every decision to have any an injection, including more than one injection, is treated with the respect we would want for our family members and loved ones
http://www.ncbi.nlm.nih.gov/pubmed/23780532
First, this is a well designed retrospective study. All retrospective studies have some limitations because of some biases that can affect reporting, so that must be kept in mind. The sample pool was a total of 6000 patients out of a database of 50,345, which is a large study.
The looked at 3000 patients who has lumbar epidural steroid injections, and compared these patients to 3000 with low back pain who did not have an epidural steroid injection.
No significant difference was found between the two groups in terms of their baseline characteristics. However, the risk of compression fractures did increase with additional injections.
Bottom line: What does this mean for our patients?
- Spine injections can be a helpful to manage patients with spine conditions, and we perform these injections with guidance (either fluoroscopy or ultrasound) to minimize the need for multiple injections
- One of the risks with any type of corticosteroid injection ("cortisone shots") is that it can weaken bone, including possibly causing a compression fracture
- The risk of compression fractures did increase when patients had multiple injections
- Because of this risk, the physicians as Lake Washington Sports & Spine take care to work with the patient to make sure they understand the risks associated with any decision to have an injection
- We pride ourselves on trying to minimize the total number of injectons the patient needs. It is common for patients to be offered a "series of three" injections, in hopes that one injection may work. That is not our general approach. Every decision to have any an injection, including more than one injection, is treated with the respect we would want for our family members and loved ones
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