Zoledronic Acid Attenuates Early Bone Loss at Forearm in Patients with Acute Spinal Cord Injury

Indian Journal of Orthopaedics, 2020 · DOI: 10.1007/s43465-020-00158-8 · Published: June 2, 2020

Spinal Cord Injury Orthopedics Musculoskeletal Medicine

Simple Explanation

This study investigates bone loss in the forearm of patients with acute spinal cord injury (SCI). It explores whether early administration of Zoledronic acid can prevent this bone loss. Sixty patients with acute SCI were divided into two groups: one receiving standard care and the other receiving Zoledronic acid in addition to standard care. Bone mineral density was measured at the forearm over 12 months. The study found that Zoledronic acid significantly reduced bone loss in both paraplegic and quadriplegic patients compared to standard treatment.

Study Duration

12 months

Participants

60 patients with acute SCI

Evidence Level

Level 1, Randomized controlled trial

Key Findings

1
Significant differences in aBMD were found between the control and Zoledronic acid groups at various forearm sites in paraplegic patients one year after SCI.
2
Similar significant differences in aBMD were observed at forearm sites in quadriplegic patients one year after SCI.
3
Zoledronic acid was well-tolerated with no significant adverse reactions reported.

Research Summary

This randomized controlled trial assessed the effect of early zoledronic acid administration on bone loss in acute SCI patients. aBMD was measured at the forearm at baseline and at 3, 6, and 12 months. The results showed significant differences in aBMD between the control and zoledronic acid groups in both paraplegic and quadriplegic patients, indicating that zoledronic acid helps prevent bone loss. The study concludes that a single dose of zoledronic acid is effective in preventing bone loss at the forearm for 12 months following acute SCI, but further treatment may be needed due to ongoing bone resorption.

Practical Implications

Clinical Practice

Early administration of zoledronic acid can be considered for patients with acute SCI to mitigate early bone loss.

Rehabilitation

Maintaining optimal aBMD is important for the rehabilitation process, including ambulation and transfer activities, in patients with SCI.

Further Research

Studies with larger sample sizes and longer follow-up periods are recommended to assess the long-term effects of zoledronic acid on bone resorption.

Study Limitations

1
The effect of rehabilitation programs on aBMD maintenance was not evaluated separately.
2
Sample sizes were relatively small, especially within subgroups.
3
Effect of rehabilitation program on maintenance of aBMD (viz. use of walking aids, assistive devices; time of start, intensity, frequency and duration of therapy programs) was not evaluated separately.

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