美國(guó)骨科醫(yī)師學(xué)會(huì)(AAOS)于1月2日在線刊登了2012年最受骨科醫(yī)生關(guān)注的10條新聞。這10條新聞涵蓋了8項(xiàng)研究和2項(xiàng)時(shí)事新聞。研究之三是:
北美脊柱年會(huì)上(NASS)報(bào)告的數(shù)據(jù)提示,使用硬膜外類固醇注射(ESI)治療背痛的患者發(fā)生椎體骨折的可能性較大。該研究團(tuán)隊(duì)回顧性研究了2007-2010年6000例治療背痛的患者,其中3840例女性,2160例男性,平均年齡66歲。一半患者接受至少一次類固醇注射,另一半患者不接受。研究者分析每組骨折發(fā)生率時(shí)發(fā)現(xiàn),每注射一次類固醇,骨折風(fēng)險(xiǎn)增加29%。
Steroid Injection Linked to Increased Risk of Bone Fractures
FOR IMMEDIATE RELEASE
Oct. 25, 2012
DETROIT – Patients treated with an epidural steroid injection for back pain relief are at increased risk of bone fractures in the spine, according to a Henry Ford Hospital study.
Researchers say the risk of fracture increased 29 percent with each steroid injection, a finding they believe raises patient safety concerns.
“For a patient population already at risk for bone fractures, steroid injections carry a greater risk that previously thought and actually pose a hazard to the bone,” says Shlomo Mandel, M.D., a Henry Ford orthopedic physician and the study’s lead author.
Dr. Mandel recommends that patients being treated with steroid injections be told about the risks associated with future fractures and undergo bone testing.
The study was accepted as a Best Paper to be presented Thursday, Oct. 25 at the annual meeting of the North American Spine Society in Dallas.
Bone fractures in the spine are the most common fracture in patients with osteoporosis, affecting an estimated 750,000 people annually. Roughly 40 percent of women aged 80 and older experience bone fractures in the spine.
Patients are typically treated with anti-inflammatory drugs and physical therapy. If symptoms persist, an epidural steroid is often prescribed to alleviate pain and improve function. However, steroid use has been linked to diminished bone quality.
In a retrospective study, researchers compared data of 6,000 patients treated for back pain between 2007 and 2010 – 3,000 patients who received at least one steroid injection and 3,000 patients who did not receive injection. The average age of patients was 66 years, and 3,840 were women and 2,160 were men. Researchers also analyzed the incidence of bone fractures in each group. Using the survival analysis technique, researchers found that the number of steroid injections is linked with an increased likelihood of fracture.
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