Longitudinal study of bone loss in chronic spinal cord injury patients

J. Phys. Ther. Sci., 2015 · DOI: · Published: May 1, 2015

Spinal Cord Injury Musculoskeletal Medicine

Simple Explanation

This study looked at how bone density changes in people with spinal cord injuries over three years. Researchers measured bone density and certain substances in the blood that relate to bone health. The study found that bone density in the femoral neck (a part of the hip) decreased significantly over time. This decrease may be linked to changes in hormone levels and bone turnover markers in the blood. These findings suggest that people with spinal cord injuries should be regularly monitored for bone loss, particularly in the hip region, and treated to prevent fractures.

Study Duration

3 years

Participants

20 spinal cord injury patients

Evidence Level

Longitudinal prospective study

Key Findings

1
Femoral neck T score, a measure of bone density, decreased significantly at 36 months compared to baseline.
2
Parathyroid hormone and vitamin D levels were significantly elevated at 12 and 36 months.
3
Bone turnover markers (deoxypyridinoline and osteocalcin) were significantly decreased at 12 and 36 months.

Research Summary

This prospective longitudinal study evaluated the changes in bone metabolism markers and bone mineral density of spinal cord injury patients over 3 years. Femoral neck T score decreased significantly at 36 months (p < 0.05). Among the hormonal markers, parathyroid hormone and vitamin D were significantly elevated, while bone turnover markers (i.e., deoxypyridinoline and osteocalcin) were significantly decreased at 12 and 36 months (p < 0.05). Bone mineral density of the femoral neck decreases significantly during the long-term follow-up of patients with spinal cord injury due to osteoporosis. This could be due to changes in hormonal and bone turnover markers.

Practical Implications

Long-term Monitoring

Patients with SCI should be monitored over the long term for osteoporosis, which may develop at the distal femur.

Antiresorptive treatment

SCI patients should receive appropriate antiosteoporotic treatment if necessary.

Physical mobility

The study suggests the importance of physical mobility in SCI patients

Study Limitations

1
The fact that SCI patients were monitored after the acute period can be considered a limitation of this study.
2
The absolute number of patients in the present study was low
3
numbers of complete/incomplete SCI and paraplegic/quadriplegic patients were insufficient, precluding statistical analyses of these patients

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