Lumbar epidural steroid injection linked to spine fractures

Lumbar epidural steroid injections have been linked to low bone density.

Lumbar epidural steroid injections have been linked to low bone density.

Providing care for long-term back and spine issues can be a complicated process made easier with chiropractic EHR systems. For instance, this technology provides comprehensive patient history in an intuitive format, helping healthcare providers review how often patients receive treatments such as lumbar epidural steroid injections, or LESI. Recently, a team of researchers found one very important reason why chiropractors may want to keep tabs on this. 

In a report published in the Journal of Bone and Joint Surgery, scientists explain that they discovered LESIs are associated with an increased risk of low bone density and spine fractures. They noted that older women, people who previously experienced a fracture, smokers and underweight individuals are particularly at high risk of bone weakness following LESI. 

"In the appropriate setting, and for the right patient, LESI provides effective symptomatic relief and improved level of function," said Shlomo Mandel, M.D., MPH, lead author and orthopaedic surgeon at Henry Ford Health System, in a release. "Through careful screening and monitoring steroid exposure, the risk of a fracture can be minimized. As orthopaedic surgeons who specialize in spine, we know there is a role for injection therapy, but the challenge is to make sure it is administered safely and still provide long-term benefits."

The researchers reached their conclusions by examining data from more than 50,000 patients, 3,415 of which had received an LESI at some point. When comparing these patients to a control group, the team of scientists discovered that each injection following the initial treatment resulted in a 21 percent increase in the risk of spinal fracture.

Authors of the study said their findings indicate that healthcare providers should carefully weigh the benefits and drawbacks of LESI. They recommended that chiropractors and doctors consider patients' history of symptoms, current physical state and imaging results when deciding whether LESI is appropriate. Practitioners who use chiropractic EHR software may find analyzing patient history easier with the technology than with paper charts. 

Other purposes for LESI
According to Spine-Health, LESIs have been used since the 1950s, and continue as a popular means of non-surgical treatment of conditions like sciatica. They've proven effective at temporarily alleviating back pain by reducing inflammation, and are often use in conjunction with physical therapy stretched and exercises.

The medical source adds that certain individuals are not well-suited for LESI. These patients include those with a local or systemic infection, pregnant women and people who are on blood thinners or have hemophilia. Finally, healthcare providers should ask patients about their current medication regimen and whether they have conditions like renal disease, congestive heart failure or diabetes, as these factors may cause adverse reactions to LESI. Noting the aforementioned details in chiropractic EHR can help doctors provide the best care possible.

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