PM&R
Volume 1, Issue 3 , Pages 240-244 , March 2009

VA-Based Survey of Osteoporosis Management in Spinal Cord Injury

  • Leslie R. Morse, DO

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA†
    • Corresponding Author InformationAddress correspondence to: L.R.M.; Department of PMR, Harvard Medical School, The Forsyth Institute, 140 The Fenway, Boston, MA 02118
    • ,
  • Lora Giangregorio, PhD

      Affiliations

    • Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada‡
    • ,
  • Ricardo A. Battaglino, PhD

      Affiliations

    • Department of Cytokine Biology, Forsyth Institute, Boston, MA§
    • ,
  • Robert Holland, MD

      Affiliations

    • Staten Island University Hospital, Staten Island, NY
    • ,
  • B. Catharine Craven, MD

      Affiliations

    • Department of Medicine, Toronto Rehabilitation Institute, University of Toronto, Canada∥
    • ,
  • Kelly L. Stolzmann, MS

      Affiliations

    • Research and Development Service, Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA and Programs in Research at VA Boston, Harvard Medical School, Boston, MA#
    • ,
  • Antonio A. Lazzari, MD, PhD, CCD

      Affiliations

    • Research and Development Service, Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA, Division of Primary Care and Rheumatology Section, VA Boston Healthcare System, Boston, MA, and Boston University School of Medicine, Boston, MA⁎⁎
    • ,
  • Sunil Sabharwal, MD

      Affiliations

    • Spinal Cord Injury Service, VA Boston Health Care System, Boston, MA, and Harvard Medical School, Boston, MA††
    • ,
  • Eric Garshick, MD

      Affiliations

    • Research and Development Service, Department of Veterans’ Affairs, Boston Healthcare System, Boston, MA; Pulmonary and Critical Care Medicine Section, Medical Service, VA Boston, MA; Channing Laboratory Department of Medicine, Brigham and Women’s Hospital, Boston, MA; Harvard Medical School, Boston, MA‡‡

Received 25 September 2008 ,Accepted 21 October 2008.

References 

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  2. Garland DE, Stewart CA, Adkins RH, et al. Osteoporosis after spinal cord injury. J Orthop Res. 1992;10:371–378
  3. de Bruin ED, Vanwanseele B, Dambacher MA, Dietz V, Stussi E. Long-term changes in the tibia and radius bone mineral density following spinal cord injury. Spinal Cord. 2005;43:96–101
  4. Demirel G, Yilmaz H, Paker N, Onel S. Osteoporosis after spinal cord injury. Spinal Cord. 1998;36:822–825
  5. Finsen V, Indredavik B, Fougner KJ. Bone mineral and hormone status in paraplegics. Paraplegia. 1992;30:343–347
  6. Frey-Rindova P, de Bruin ED, Stussi E, Dambacher MA, Dietz V. Bone mineral density in upper and lower extremities during 12 months after spinal cord injury measured by peripheral quantitative computed tomography. Spinal Cord. 2000;38:26–32
  7. Tsuzuku S, Ikegami Y, Yabe K. Bone mineral density differences between paraplegic and quadriplegic patients: a cross-sectional study. Spinal Cord. 1999;37:358–361
  8. Biering-Sorensen F, Bohr HH, Schaadt OP. Longitudinal study of bone mineral content in the lumbar spine, the forearm and the lower extremities after spinal cord injury. Eur J Clin Invest. 1990;20:330–335
  9. de Bruin ED, Frey-Rindova P, Herzog RE, Dietz V, Dambacher MA, Stussi E. Changes of tibia bone properties after spinal cord injury: effects of early intervention. Arch Phys Med Rehabil. 1999;80:214–220
  10. de Bruin ED, Dietz V, Dambacher MA, Stussi E. Longitudinal changes in bone in men with spinal cord injury. Clin Rehabil. 2000;14:145–152
  11. Wilmet E, Ismail AA, Heilporn A, Welraeds D, Bergmann P. Longitudinal study of the bone mineral content and of soft tissue composition after spinal cord section. Paraplegia. 1995;33:674–677
  12. Comarr AE, Hutchinson RH, Bors E. Extremity fractures of patients with spinal cord injuries. Am J Surg. 1962;103:732–739
  13. Eser P, Frotzler A, Zehnder Y, Schiessl H, Denoth J. Assessment of anthropometric, systemic, and lifestyle factors influencing bone status in the legs of spinal cord injured individuals. Osteoporos Int. 2005;16:26–34
  14. Morse LR, Battaglino RA, Stolzmann KL, et al. Osteoporotic fractures and hospitalization risk in chronic spinal cord injury. Osteoporos Int. 2008;June 26. [Epub ahead of print]
  15. Ragnarsson KT, Sell GH. Lower extremity fractures after spinal cord injury: a retrospective study. Arch Phys Med Rehabil. 1981;62:418–423
  16. Freehafer AA, Hazel CM, Becker CL. Lower extremity fractures in patients with spinal cord injury. Paraplegia. 1981;19:367–372
  17. Vestergaard P, Krogh K, Rejnmark L, Mosekilde L. Fracture rates and risk factors for fractures in patients with spinal cord injury. Spinal Cord. 1998;36:790–796
  18. Garland DE. Clinical observations on fractures and heterotopic ossification in the spinal cord and traumatic brain injured populations. Clin Orthop Relat Res. 1988;86–101
  19. Gilchrist NL, Frampton CM, Acland RH, et al. Alendronate prevents bone loss in patients with acute spinal cord injury: a randomized, double-blind, placebo-controlled study. J Clin Endocrinol Metab. 2007;92:1385–1390
  20. Zehnder Y, Risi S, Michel D, et al. Prevention of bone loss in paraplegics over 2 years with alendronate. J Bone Miner Res. 2004;19:1067–1074
  21. Bauman WA, Morrison NG, Spungen AM. Vitamin D replacement therapy in persons with spinal cord injury. J Spinal Cord Med. 2005;28:203–207
  22. Kunkel CF, Scremin AM, Eisenberg B, Garcia JF, Roberts S, Martinez S. Effect of “standing” on spasticity, contracture, and osteoporosis in paralyzed males. Arch Phys Med Rehabil. 1993;74:73–78
  23. Needham-Shropshire BM, Broton JG, Klose KJ, Lebwohl N, Guest RS, Jacobs PL. Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system: part 3 (Lack of effect on bone mineral density). Arch Phys Med Rehabil. 1997;78:799–803
  24. Dauty M, Perrouin VB, Maugars Y, Dubois C, Mathe JF. Supralesional and sublesional bone mineral density in spinal cord-injured patients. Bone. 2000;27:305–309
  25. Liu D, Li H, Zhao CQ, Jiang LS, Dai LY. Changes of substance P-immunoreactive nerve fiber innervation density in the sublesional bones in young growing rats at an early stage after spinal cord injury. Osteoporos Int. 2008;19:559–569
  26. Morse LR, Nguyen HP, Jain N, et al. Age and motor score predict osteoprotegerin level in chronic spinal cord injury. J Musculoskelet Neuronal Interact. 2008;8:50–57

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

 The project reported/outlined here was supported by the Office of Research and Development, Health Services R&D Service, Quality Enhancement Research Initiative RRP-07-312, NIH/NICHD RO1 HD42141 (Dr. Garshick), R21HD057030 (Morse), and K12 HD001097-08 (Dr. Morse).

 The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

PII: S1934-1482(08)00019-1

doi: 10.1016/j.pmrj.2008.10.008

PM&R
Volume 1, Issue 3 , Pages 240-244 , March 2009

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