Abstract
(HR=0.99) or LSJI (HR=0.96). Long term steroid use increased spine fracture risk in ESI (HR=1.86) and LJSI patients (HR=1.41). Osteoporotic hip fracture risk was influenced by age, race, sex, CCMI, Cushing’s disease, LJSI (HR=0.95) and TSI (HR=0.95), but not ESI. Osteoporotic wrist fracture risk was influenced by age, race, sex, CCMI, LJSI (HR=0.91), but not by ESI or TSI. Conclusions Analysis of patients in the Medicare database showed that ESI, TSI or LJSI decreased osteoporotic spine fracture risk; but this may not be clinically relevant. Successive ESIs did not influence osteoporotic hip or wrist fracture risk, while LJSIs reduced the risk. Prolonged steroid exposure increases spine fracture risk in ESI and LJSI patients. Acute exposure to exogenous steroids via the epidural space, transforaminal space or large joints does not seem to increase the risk of an osteoporotic fracture of the spine, hip or wrist.
Highlights
A recent study showed that lumbar epidural steroid injections increased osteoporotic spine fracture risk
Aim We further evaluated associations between steroid injections and osteoporotic fracture risk by analyzing the Medicare database and including large joint and transforaminal steroid injections; as well as osteoporotic hip and wrist fractures
Osteoporotic hip fracture risk was influenced by age, race, sex, Charlson Comorbidity Index (CCMI), Cushing’s disease, LJSI (HR=0.95) and transforaminal space (TSI) (HR=0.95), but not ESI
Summary
Risk of osteoporotic fracture after steroid injections in Medicare patients Leah Carreon1*, Kevin Ong, Edmund Lau, Steven Kurtz, Steven Glassman. From 11th International Conference on Conservative Management of Spinal Deformities - SOSORT 2014 Annual Meeting Wiesbaden, Germany. 8-10 May 2014
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