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.
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