ReviewOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2021
The skeletal consequences of epidural steroid injections: a literature review.
Review in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Minimally Invasive Spinal Interventions for Back and Neck Pain in the Pediatric Population: a Systematic Review.Current pain and headache reports · 2026Pooled it
- Therapeutic interventions of platelet-rich plasma versus corticosteroid injections for lumbar radicular pain: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Comparative effectiveness of dexamethasone versus methylprednisolone for neuropathic outcomes after combined spinal-epidural labor analgesia: a prospective, randomized, double-blind trial.Frontiers in medicine · 2026Trial
- FactFinders for patient safety: Do epidural steroid injections increase the risk of fracture or lumbar surgical site infection?Interventional pain medicine · 2025Article
- Diverse clinical manifestations and management strategies in autoimmune polyglandular syndrome: a review of cases.Annals of medicine and surgery (2012) · 2025Review
- Does Intra-Operative Posterior Facet Steroid Injection in Lumbar Laminectomy Decreases Post-Operative Low Back Pain? A randomized Clinical Trial.The archives of bone and joint surgery · 2025Article
- Comparative effectiveness and safety of herbal medicine therapy for low back pain and radiculopathy caused by lumbar intervertebral disc herniation: a study protocol for a pragmatic randomized controlled trial.Frontiers in neurology · 2025Article
- Increased Risk of Osteoporotic Vertebral Compression Fractures Following Epidural Steroid Injections in Patients with Lumbar Degenerative Disease: A Retrospective Cohort Study.Journal of clinical medicine · 2024Article
- Corticosteroid Injections and Risk of Fracture.JAMA network open · 2024Article
- An update on epidural steroid injections: is there still a role for particulate corticosteroids?Skeletal radiology · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This literature review summarized studies that evaluated the effects of epidural steroid injections (ESIs) on skeletal health. While evidence is limited, studies suggest that ESIs may cause bone loss. Better understanding of these skeletal consequences will help foster strategies to prevent bone loss in the growing population of patients receiving ESIs. PURPOSE: Approximately nine million epidural steroid injections (ESIs) are administered annually in the United States to treat radicular back pain. ESIs often provide pain relief and functional improvement. While the overall incidence of adverse events resulting from ESIs is low, their effects on the skeleton are poorly understood. This is an important consideration given the profound skeletal impact of other forms of glucocorticoids.
methodsOvid MEDLINE and PubMed search results since 2010, including older, frequently referenced publications were reviewed.
resultsSystemic absorption of glucocorticoids occurs after ESI, which can cause hyperglycemia and endogenous cortisol suppression. The majority of studies investigating the skeletal effects of ESIs are retrospective. Several have found a relationship between low areal bone mineral density (BMD) by dual-energy x-ray absorptiometry and ESI exposure, but this finding is not uniform. Recently a dose-response relationship between ESI exposure and low spine volumetric BMD by computed tomography has been reported. Few studies have investigated the relationship between ESI exposure and fracture risk. Results of these studies are conflicting, and most have not been adequately powered to detect fracture outcomes.
conclusionsWhile evidence is limited, studies suggest that ESIs may cause bone loss, particularly those investigating volumetric BMD. Larger doses appear to confer greater risk. Further prospective studies are needed to investigate the relationship between ESI and fracture risk. Better understanding of the skeletal consequences of ESIs will help foster strategies to prevent bone loss in the growing population of patients receiving this treatment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.