title: Relationship between bone mineral density and the frequent administration of epidural steroid injections in postmenopausal women with low back pain.
abstract: BACKGROUND
  Epidural steroid injection (ESI) is one of the most common nonsurgical treatments for low back pain. In general, corticosteroid therapy often results in bone loss and osteoporosis. In previous studies, bone mineral density (BMD) was evaluated after epidural injections of relatively small numbers and relatively low total doses of corticosteroids. However, the relationship between BMD and multiple ESIs remains to be elucidated.
  
  
  OBJECTIVE
  To explore the relationship between BMD and multiple ESIs in postmenopausal women with low back pain.
  
  
  METHODS
  Medical records of postmenopausal women with low back pain treated with or without ESIs were reviewed. BMD was measured in the lumbar spine, femoral neck and total femur after the treatments. A total of 71 patients were divided into two groups: group 1 included patients who had received non-ESI medications; and group 2 included those who had received ESIs >10 times, with a cumulative administered triamcinolone dose >200 mg.
  
  
  RESULTS
  Patients in group 2 showed lower BMD in the femoral neck and total femur. However, no significant intergroup differences in the BMD of the lumbar spine were observed. The prevalences of osteoporosis and osteopenia in the lumbar spine and femoral neck were significantly higher in group 2; these patients also had lower femoral neck BMD Z-scores.
  
  
  CONCLUSIONS
  Multiple ESIs (approximately 14 injections with a cumulative triamcinolone dose of approximately 400 mg) can reduce BMD in postmenopausal women with low back pain.
authors.forename: Sungyun
authors.initials: S
authors.lastname: Kim
authors.forename: Byeongmun
authors.initials: B
authors.lastname: Hwang
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects*; D000368:Aged; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007268:Injections, Epidural; D017116:Low Back Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism*; D008875:Middle Aged; D017698:Postmenopause / Q000187:drug effects / Q000378:metabolism*; D012189:Retrospective Studies
chemical_list: D000305:Adrenal Cortex Hormones