Spinal cord injury-related osteoporosis poses its own challenges

Individuals with spinal cord injuries (SCIs) have a significant risk of developing osteoporosis in paralyzed body regions, so much so that researchers recently released a study asserting the need for more education on the topic among both patients and physicians.

The report, which appears in the journal Archives of Physical Medicine and Rehabilitation, uses as clinical evidence the incidence of osteoporosis-related fractures among 32 patients with SCIs.

The average age of these participants was 53. All of them had previously suffered a paralyzing injury to the spine, and all were wheelchair-dependent. Researchers found that all 32 individuals had suffered at least one post-SCI fracture, usually in the lower limbs.

Among people with SCIs, osteoporosis is quite common. A paper published in the journal Research Reviews (RR) states that a person's metabolism changes shortly after the onset of paralysis, due to the precipitous drop in muscle use.

During the 16 months following spinal injury, individuals with SCIs quickly lose large amounts of calcium through their urine, regardless of their age or gender, the report states.

The authors add that the combination of decalcification and reduced strain on the bones causes what is known as "disuse osteoporosis."

The RR report also notes that statistically, one-third of patients with SCIs experience at least one post-injury fracture within 15 years of the onset of paralysis.

In the new study, nine patients suffered two or more disuse osteoporosis-related fractures, including two participants who broke bones on four separate occasions. Nearly all of these injuries occurred due to falls from, or transfers between, wheelchairs. Two fractures appeared after no apparent trauma.

The most commonly broken bone was the femur. Among all Americans with osteoporosis, this injury occurs nearly 300,000 times each year, according to the National Osteoporosis Foundation.

Researchers concluded that physicians and caretakers should be aware of the common causes of fracture for people with SCIs, and that those with the injury should be educated about disuse osteoporosis.

"Osteoporosis is a reality [for those with SCIs], occurring early and lasting for the long term," the study's authors emphasized. "There is an early and constant risk for fracture regardless of the patient’s age, age of the initial SCI and additional risk factors."