Diagnosis and treatment of osteoporosis in spinal cord injury patients: A literature review

Abstract Objective To present an up-to-date literature review of osteoporosis in spinal cord injury (SCI) patients, in view of the seriousness of this complication (with a high risk of fractures) and the complexity of its diagnosis, evaluation and treatment. Methods A Medline search with the following keywords: immobilization osteoporosis, spinal cord injury, bone loss, dual energy X-ray absorptiometry (DEXA), bisphosphonate. Results Our analysis of the literature noted a bone metabolism imbalance in SCI patients, with accelerated early bone resorption (particularly during the first 6 months post-injury). Although dual energy X-ray absorptiometry constitutes the “gold standard” diagnostic method, the decrease in bone mineral density only becomes significant 12 months after the injury. Bisphosphonate therapy has proven efficacy. Despite the frequent use of various physical therapies, these methods have not been found to be effective. Conclusion Although our literature review did not identify any guidelines on the strategy for diagnosing and treating osteoporosis in SCI patients, several findings provide guidance on procedures for early diagnosis and preventive treatment.