Osteoporosis after spinal cord injury : aetiology, effects and therapeutic approaches

Abdelrahman, Shima and Ireland, Alex and Winter, Elizabeth M. and Purcell, Mariel and Coupaud, Sylvie (2021) Osteoporosis after spinal cord injury : aetiology, effects and therapeutic approaches. The Journal of Musculoskeletal and Neuronal Interactions, 21 (1). pp. 26-50. ISSN 1108-7161 (http://www.ismni.org/jmni/pdf/83/jmni_21_026.pdf)

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Abstract

Osteoporosis is a long-term consequence of spinal cord injury (SCI) that leads to a high risk of fragility fractures. The fracture rate in people with SCI is twice that of the general population. At least 50% of these fractures are associated with clinical complications such as infections. This review article presents key features of osteoporosis after SCI, starting with its aetiology, a description of temporal and spatial changes in the long bones and the subsequent fragility fractures. It then describes the physical and pharmacological approaches that have been used to attenuate the bone loss. Bone loss after SCI has been found to be highly site-specific and characterised by large inter-variability and site-specific changes. The assessment of the available interventions is limited by the quality of the studies and the lack of information on their effect on fractures, but this evaluation suggests that current approaches do not appear to be effective. More studies are required to identify factors influencing rate and magnitude of bone loss following SCI. In addition, it is important to test these interventions at the sites that are most prone to fracture, using detailed imaging techniques, and to associate bone changes with fracture risk. In summary, bone loss following SCI presents a substantial clinical problem. Identification of at-risk individuals and development of more effective interventions are urgently required to reduce this burden.

ORCID iDs

Abdelrahman, Shima, Ireland, Alex, Winter, Elizabeth M., Purcell, Mariel and Coupaud, Sylvie ORCID logoORCID: https://orcid.org/0000-0003-3595-3402;
  • Item type:Article
    ID code:74535
    Dates:
    Date
    Event
    1 March 2021
    Published
    6 November 2020
    Published Online
    27 October 2020
    Accepted
    14 February 2020
    Submitted
    Subjects:Medicine > Internal medicine
    Department:Faculty of Engineering > Biomedical Engineering
    Depositing user: Pure Administrator
    Date deposited:06 Nov 2020 14:52
    Last modified:11 Nov 2024 12:41
    URI:https://strathprints.strath.ac.uk/id/eprint/74535
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