Background:
Spinal cord injury (SCI) is associated with a rapid loss of bone mass, resulting in severe osteoporosis and a 5- to 23-fold increase in fracture risk. Despite the seriousness of fractures in SCI, there are multiple barriers to osteoporosis diagnosis and wide variations in treatment practices for SCI-induced osteoporosis.
Methods:
We review the biological and structural changes that are known to occur in bone after SCI in the context of promoting future research to prevent or reduce risk of fracture in this population. We also review the most commonly used methods for assessing bone after SCI and discuss the strengths, limitations, and clinical applications of each method.
Conclusions:
Although dual-energy x-ray absorptiometry assessments of bone mineral density may be used clinically to detect changes in bone after SCI, 3-dimensional methods such as quantitative CT analysis are recommended for research applications and are explained in detail.
Acknowledgments
All authors have no conflicts of interest. This study received support from the US Department of Education, National Institute on Disability and Rehabilitation Research (H133N110010), and the National Institutes of Health (AR059270 and HD056721 to L.R.M.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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