Musculoskeletal morbidity following spinal cord injury: A longitudinal cohort study of privately-insured beneficiaries

Bone, 2021 · DOI: 10.1016/j.bone.2020.115700 · Published: January 1, 2021

Spinal Cord Injury Rehabilitation Musculoskeletal Medicine

Simple Explanation

Spinal cord injuries (SCIs) can lead to motor, sensory, and autonomic impairments, causing musculoskeletal disorders that worsen over time. The severity of these issues depends on the injury's level and completeness. This study compared the occurrence of musculoskeletal problems in adults with and without SCIs. It found that those with SCIs had a significantly higher incidence of these issues. Adults with SCIs are more likely to develop musculoskeletal issues like osteoporosis, sarcopenia, osteoarthritis, and fractures. This highlights the need for better screening and early interventions for this population.

Study Duration

5 Years

Participants

9,081 adults with SCI and 1,474,232 adults without SCI

Evidence Level

Not specified

Key Findings

1
Adults with SCIs had a significantly higher incidence of any musculoskeletal morbidities (82.4% vs. 47.5%) compared to those without SCIs.
2
Adults with SCI had higher rates of osteoarthritis (40.2% vs 18.6%), osteoporosis (24.0% vs 6.2%) and pathologic fracture (20.2% vs 1.4%) compared to adults without SCI.
3
Adults with SCI demonstrated a greater hazard for any musculoskeletal morbidity (HR: 2.41; 95%CI: 2.30-2.52).

Research Summary

This study examined the incidence of musculoskeletal disorders in adults with spinal cord injuries (SCIs) compared to those without. The findings revealed a significantly higher incidence of musculoskeletal morbidities among individuals with SCIs. The study utilized survival models to assess the risk of developing musculoskeletal issues, demonstrating a greater hazard for any musculoskeletal morbidity in adults with SCIs. The conclusion emphasizes the necessity for increased clinical awareness, improved screening strategies, and the development of efficient referral resources to reduce the burden of musculoskeletal disorders in the SCI population.

Practical Implications

Enhanced Clinical Screening

Development of improved clinical screening algorithms to identify musculoskeletal disorders early in adults with SCI.

Early Interventions

Implementation of early interventions to reduce the risk of musculoskeletal disease onset and progression in the higher-risk SCI population.

Coordinated Care Resources

Creation of efficient referral resources to facilitate coordinated care for individuals with SCI, addressing their specific musculoskeletal health needs.

Study Limitations

1
Inability to analyze specific processes of musculoskeletal disorders over a period of time.
2
Inability to determine cause and effect of these disorders.
3
The severity of SCI could not be determined through claims-based data.

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