scholarly journals Low Bone Mineral Density, But Not Epidural Steroid Injection, Is Associated with Fracture in Postmenopausal Women with Low Back Pain

2012 ◽  
Vol 6;15 (6;12) ◽  
pp. 441-449
Author(s):  
Byeongmun Hwang
Keyword(s):  
Bone Mineral Density ◽  
Low Back Pain ◽  
Back Pain ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Low Back ◽  
Mineral Density ◽  
Epidural Steroid

Background: Therapy with glucocorticoids often results in bone loss and glucocorticoidinduced osteoporosis. However, the relationship between epidural steroid injection (ESI), bone mineral density (BMD), and vertebral fracture remains to be determined. Objective: To establish a relationship between ESI, BMD, and vertebral fracture in postmenopausal women with low back pain. Study Design: This study was a retrospective, nonblinded, cross-sectional clinical study. Setting: University-based pain management center. Methods: We reviewed the medical records of postmenopausal women with low back pain who were treated with ESI. A total of 352 postmenopausal women were divided into 2 groups. Group 1 consisted of patients without fracture and Group 2 consisted of those with fractures. The results of BMD measurements, as well as any fragility fractures, the anatomical site involved, and the treatment administered, were also recorded. BMD was measured in the lumbar spine, femoral neck, and total femur after the treatment. Results: Of the 352 patients, 218 (62%) had no fractures while 134 (38%) sustained a fracture. The age was significantly higher among patients who sustained fractures, and BMD at the lumbar spine, total femur, and femoral neck regions was significantly lower among patients who sustained fractures. In each region, the prevalence of osteoporosis was significantly higher in patients with fracture than in patients without fracture (all P < 0.05). Age, height, and weight were associated with low BMD. However, our study showed no consistent correlation between BMD and the mean number of ESIs, mean total dose of glucocorticoids, or mean duration of ESIs. Limitations: First, this study is limited by the fact that it was retrospective. Second, the number of cases receiving very frequent, high-dose glucocorticoid injections was very small. Conclusions: Older age and lower BMD were associated with osteoporotic fracture in postmenopausal women treated for low back pain with ESI. The ESIs were not associated with low BMD or fracture. Key words: Bone mineral density, epidural steroid injection, fracture, glucocorticoids, low back pain, postmenopause.

scholarly journals Bone mineral density, body mass index, postmenopausal period and outcomes of low back pain treatment in Korean postmenopausal women

2010 ◽  
Vol 19 (11) ◽  
pp. 1942-1947 ◽  
Author(s):  
Jongbae J. Park ◽  
Joonshik Shin ◽  
Yousuk Youn ◽  
Catherine Champagne ◽  
Eunseok Jin ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Body Mass Index ◽  
Low Back Pain ◽  
Back Pain ◽  
Postmenopausal Women ◽  
Body Mass ◽  
Bone Mineral ◽  
Pain Treatment ◽  
Low Back ◽  
Mineral Density

Effect of Epidural Steroid Injection on Bone Mineral Density and Markers of Bone Turnover in Postmenopausal Women

Spine ◽  
2012 ◽  
Vol 37 (25) ◽  
pp. E1567-E1571 ◽  
Author(s):  
Ahmad Al-Shoha ◽  
D. Sudhaker Rao ◽  
Jennifer Schilling ◽  
Edward Peterson ◽  
Shlomo Mandel
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Mineral Density ◽  
Markers Of Bone Turnover ◽  
Epidural Steroid

scholarly journals Effect of Epidural Steroid Injection on Bone Mineral Density in Postmenopausal Women According to Antiosteoporotic Medication Use

2016 ◽  
Vol 6;19 (6;7) ◽  
pp. 389-396
Author(s):  
Jeong Hun Suh
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Mineral Density ◽  
Group 2 ◽  
Epidural Steroid

Background: No studies to date have compared bone mineral density (BMD) changes after epidural steroid injection (ESI) between postmenopausal patients taking antiosteoporotic medication and those who are not. Objective: The aim of the present study was to analyze the relationship between ESI and BMD changes in postmenopausal patients according to antiosteoporotic medication use. Study Design: Retrospective analysis. Setting: Department of Anesthesiology and Pain Medicine at Asan Medical Center, Korea. Methods: We retrospectively analyzed postmenopausal women who underwent ESI using dexamethasone. All women had received a diagnosis of lumbar spinal stenosis and their BMD had been measured before and after treatment. BMD was evaluated by dual-energy x-ray absorptiometry at the lumbar spine, femoral neck, femoral trochanter, and total femur, and was recorded as absolute g/cm2 and T-scores. A total of 126 patients were included in the final analysis. ESI patients were grouped as follows: group 1 (n = 74) ESI patients who took antiosteoporotic medication; group 2 (n = 52) ESI patients who did not take antiosteoporotic medication. Results: In group 1, there were no significant differences between baseline and post-treatment BMD absolute values (g/cm2) in the lumbar spine, femoral neck, femoral trochanter, and total femur. In group 2, significant changes in the post-treatment BMD absolute values (g/cm2) from baseline were observed in the femoral neck (–1.48 ± 3.84%), femoral trochanter (–2.80 ± 7.50%), and total femur (–2.23 ± 4.52%), but not in the lumbar spine (–2.23 ± 4.52%). Limitations: This study contained a small sample size, no control group, and no long-term follow-up of the BMD changes after ESI. Conclusions: Our data provide new evidence indicating that ESI causes BMD changes in postmenopausal women who do not take antiosteoporotic medication. Thus, we recommend that prophylactic antiosteoporotic treatment be considered for postmenopausal women who require ESI treatment. Keywords: Glucocorticoid, osteoporosis, bone mineral density, epidural steroid injection, antiosteoporotic medication, postmenopausal women, dexamethasone

EFFECTIVENESS OF EPIDURAL STEROID INJECTION FOR THE MANAGEMENT OF CHRONIC LOW BACK PAIN.

2021 ◽  
pp. 52-54
Author(s):  
Ravi Ranjan Singh ◽  
Bharat Singh
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Steroid Injection ◽  
Lumbar Disc ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Low Back ◽  
Herniated Lumbar Disc ◽  
Epidural Steroid

INTRODUCTION: Low-back pain is a common clinical presentation of herniated lumbar disc. The incidence of low back pain is high in our country due to difcult working and living environment. The initial treatment of low back pain is conservative. Epidural steroid injection (ESI) is being slowly established as a simple, effective and minimally invasive treatment modality. The aim of this study is to assess the effectiveness of epidural steroid injection for low back and radicular pain. MATERIALS AND METHODS :This is a Prospective observational study. It was carried out on the patients presenting with low back pain due to herniated lumbar disc not responding to conservational management and had Magnetic Resonance Imaging (MRI) proven lumbar disc prolapsed at different level. Injection Methyl prednisolone 80 mg and 2 ml of 0.5% bupivacaine was diluted in 8 ml of normal saline and injected into the affected lumbar epidural space. The functional status of the patient and the severity of pain were evaluated before injection and after injection during the follow-up period by using Ostrewy disability index and visual analogue score. RESULTS: Fifty six patients received the epidural steroid injections, among them three patients did not came for regular follow up till six months and six patients required surgery . remaining forty seven were analyzed , among them 27(55.44%) were male and 20(42.55%) were female. The functional status and pain response of the patients were improved signicantly during all the follow-up periods (p < 0.001). The success rate of this study was 83.92%. No major complications were encountered. CONCLUSION:The ESI is a simple, safe, effective and minimally invasive modality for the management of lumbar radicular pain.

Impact of three-dimensional chemoradiation on pelvic bone mineral density, low back pain, and disability in cervical cancer: a prospective study

2021 ◽  
pp. ijgc-2020-002290
Author(s):  
Divyesh Kumar ◽  
Raviteja Miriyala ◽  
Bhavana Rai ◽  
Pooja Bansal ◽  
Arun S Oinam ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Cervical Cancer ◽  
Low Back Pain ◽  
Back Pain ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Menopausal Status ◽  
Pelvic Bone ◽  
Low Back ◽  
Mineral Density

ObjectiveTo prospectively analyze the effect of three-dimensional chemoradiation on the bone mineral density of pelvic bones and its association with low back pain and disability in patients with locally advanced cervical cancer.MethodsIn biopsy proven locally advanced cervical cancer patients, bone mineral density and T scores for lumbar vertebrae 5, dorsal thoracic vertebrae 12, and T scores for the femoral neck were analyzed. Low back pain was scored using the visual analog scale while disability scoring was done using the Oswestry low back pain disability scale. Furthermore, a subgroup analysis for patients (classified according to menopausal status) was performed.ResultsIn total, 106 patients were analyzed. A statistically significant decline in mean bone mineral density was observed at all three sites (vertebrae 5 and 12, and the femoral neck) post-chemoradiation therapy compared with pretreatment bone mineral density (0.671 vs 0.828, −2.083 vs −1.531, −2.503 vs −1.626; all p<0.001). Similarly, in subgroup analyses, at all three sites, pre-menopausal patients showed a statistically significant association (0.876 vs 0.697, −1.203 vs −0.2.761, –1.403 vs −2.232; all p<0.001) while a non-significant association was observed for post-menopausal patients at vertebrae 12 (−1.707 vs −1.719; p=0.09) with a statistically significant association at vertebrae 5 and the femoral neck (0.803 vs 0.656, –1.746 vs −2.648; p<0.01). Although statistically significant low back pain and disability scores were observed overall and irrespective of menopausal status, no correlation between bone mineral density and low back pain and disability was observed.ConclusionPelvic bone mineral density decreases significantly after chemoradiation, irrespective of menopausal status. However, no correlation with low back pain and disability was observed. Pelvic bone mineral density analysis should be considered before chemoradiation in cervical cancer.

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