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

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 revi...

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Autores principales: Abdelrahman, Shima, Ireland, Alex, Winter, Elizabeth M., Purcell, Mariel, Coupaud, Sylvie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Society of Musculoskeletal and Neuronal Interactions 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8020025/
https://www.ncbi.nlm.nih.gov/pubmed/33657753
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author Abdelrahman, Shima
Ireland, Alex
Winter, Elizabeth M.
Purcell, Mariel
Coupaud, Sylvie
author_facet Abdelrahman, Shima
Ireland, Alex
Winter, Elizabeth M.
Purcell, Mariel
Coupaud, Sylvie
author_sort Abdelrahman, Shima
collection PubMed
description 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.
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spelling pubmed-80200252021-04-08 Osteoporosis after spinal cord injury: aetiology, effects and therapeutic approaches Abdelrahman, Shima Ireland, Alex Winter, Elizabeth M. Purcell, Mariel Coupaud, Sylvie J Musculoskelet Neuronal Interact Review Article 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. International Society of Musculoskeletal and Neuronal Interactions 2021 /pmc/articles/PMC8020025/ /pubmed/33657753 Text en Copyright: © Journal of Musculoskeletal and Neuronal Interactions http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 4.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Abdelrahman, Shima
Ireland, Alex
Winter, Elizabeth M.
Purcell, Mariel
Coupaud, Sylvie
Osteoporosis after spinal cord injury: aetiology, effects and therapeutic approaches
title Osteoporosis after spinal cord injury: aetiology, effects and therapeutic approaches
title_full Osteoporosis after spinal cord injury: aetiology, effects and therapeutic approaches
title_fullStr Osteoporosis after spinal cord injury: aetiology, effects and therapeutic approaches
title_full_unstemmed Osteoporosis after spinal cord injury: aetiology, effects and therapeutic approaches
title_short Osteoporosis after spinal cord injury: aetiology, effects and therapeutic approaches
title_sort osteoporosis after spinal cord injury: aetiology, effects and therapeutic approaches
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8020025/
https://www.ncbi.nlm.nih.gov/pubmed/33657753
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