A Retrospective Analysis of Vertebral Body Fractures Following Epidural Steroid Injections

Mandel, Shlomo; Schilling, Jennifer; Peterson, Edward L.; Rao, D. Srinivasa; Sanders, William R.

doi:10.2106/jbjs.l.00844

Cited by 46 publications

(25 citation statements)

References 10 publications

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“…A large retrospective cohort study compared the data of 3,000 patients with spinal pain who received a lumbar ESI with the data of 3,000 matched controls who did not receive injections. Each ESI increased the fracture risk by 31% . It is therefore recommended to keep the corticosteroid exposure to a minimum, particularly for high‐risk patients such as the elderly and women with a prior history of osteoporosis or osteopenia …”

Section: Complications After Epidural Corticosteroids: Overviewmentioning

confidence: 99%

Safe Use of Epidural Corticosteroid Injections: Recommendations of the WIP Benelux Work Group

et al. 2018

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Section: Complications After Epidural Corticosteroids: Overviewmentioning

confidence: 99%

Safe Use of Epidural Corticosteroid Injections: Recommendations of the WIP Benelux Work Group

et al. 2018

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“…In some studies, the incidence rises with cumulative dose (146,147), but there may be an even stronger association between vertebral fracture incidence and mean daily dose (148,149). Local epidural glucocorticoid injections for spinal central or foraminal stenosis may also increase bone loss (150), and the risk of incident clinical vertebral fractures (151).…”

Section: Individual Clinical Characteristics Associated With Incidentmentioning

confidence: 99%

Epidemiology of Vertebral Fractures

Schousboe

2016

Journal of Clinical Densitometry

324

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“…particulate preparations) can inhibit recovery of the hypothalamic-pituitary axis and can lead to decreased bone mineral density (101)(102)(103). Cushingoid symptoms, although rare, can persist for several months after steroid injections have been terminated (28,104).…”

Section: How I Do It: Spinal Injections For Pain Management Palmermentioning

confidence: 99%

Spinal Injections for Pain Management

Palmer

2016

Radiology

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Image-guided spinal injection is commonly performed in symptomatic patients to decrease pain severity, confirm the pain generator, and delay or avoid surgery. This article focuses on the radiologist as spine interventionist and addresses the following four topics relevant to the radiologist who performs corticosteroid injections for pain management: (a) the rationale behind corticosteroid injection, (b) the interaction with patients, (c) the role of imaging in procedural selection and planning, and (d) the pearls and pitfalls of fluoroscopically guided injections. Factors that contribute to the success of a pain management service include communication skills and risk mitigation. A critical factor is the correlation of clinical symptoms with magnetic resonance (MR) imaging findings. Radiologists can leverage their training in MR image interpretation to distinguish active pain generators in the spine from incidental abnormalities. Knowledge of fluoroscopic anatomy and patterns of contrast material flow guide the planning and execution of safe and effective needle placement.q RSNA, 2016

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A Retrospective Analysis of Vertebral Body Fractures Following Epidural Steroid Injections

Abstract: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 46 publications

References 10 publications

Safe Use of Epidural Corticosteroid Injections: Recommendations of the WIP Benelux Work Group

Safe Use of Epidural Corticosteroid Injections: Recommendations of the WIP Benelux Work Group

Epidemiology of Vertebral Fractures

Spinal Injections for Pain Management

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