122. Spinal Cord Injury: Skeletal Pathophysiology and Clinical Issues

  1. Clifford J. Rosen MD
  1. William A. Bauman and
  2. Christopher P. Cardozo

Published Online: 19 JUL 2013

DOI: 10.1002/9781118453926.ch122

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

How to Cite

Bauman, W. A. and Cardozo, C. P. (2013) Spinal Cord Injury: Skeletal Pathophysiology and Clinical Issues, in Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition (ed C. J. Rosen), John Wiley & Sons, Inc., Ames, USA. doi: 10.1002/9781118453926.ch122

Publication History

  1. Published Online: 19 JUL 2013

ISBN Information

Print ISBN: 9781118453889

Online ISBN: 9781118453926

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Keywords:

  • acute spinal cord injury (SCI);
  • bone loss;
  • fracture;
  • heterotopic ossification (HO);
  • mechanical therapy;
  • skeletal mineral density;
  • skeletal pathophysiology

Summary

This chapter discusses several aspects of the skeletal pathophysiology, general clinical considerations, and relevant experimental findings in individuals with acute spinal cord injury (SCI) and chronic SCI. The unique sublesional skeletal resorption that occurs after SCI compared to other conditions associated with generalized, rapid, and substantial bone loss is described, as well as the far greater magnitude of the sublesional skeletal changes with SCI. In addition, the heightened risk of fracture, as well as its SCI population-specific risk factors, the occurrence of and contributing factors to heterotopic ossification (HO), and the prevalence of vitamin D deficiency in those with SCI, and the reasons for its high prevalence, are discussed. The single report to date in individuals with SCI addressed the effect of pulsed electromagnetic fields applied unilaterally at the knee in subjects at least 2 years after acute SCI.