HealthDay News — In patients with radiculopathy or neurogenic claudication due to compression of spinal nerves, lumbar epidural steroid injections (LESIs) increase the risk of vertebral fractures, study results indicate.

To examine whether LESIs increase the risk of subsequent vertebral body fracture, Shlomo Mandel, MD, MPH, and colleagues from the Henry Ford Health System in Detroit retrospectively compared the risk in 3,000 patients who had received LESIs and 3,000 matched patients who had not received injections. Findings were published in the Journal of Bone & Joint Surgery.

The researchers found that after adjusting for possible confounding factors, the fracture risk increased by a factor of 1.21 with each successive injection. The two groups were similar in terms of age, sex, race, hyperthyroidism, steroid use and predicted propensity score.

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“The findings suggest that LESIs, like other forms of exogenous steroid administration, may lead to increased bone fragility,” Mandel and colleagues conclude.

“The added exposure to glucocorticoids resulting from LESI use may carry a greater risk than previously thought, suggesting that use of LESIs should be approached cautiously in patients at risk for osteoporotic fractures.”


  1. Mandel S et al. J Bone Joint Surg Am. 2013; 95(11): 961-964.