Alendronate Prevents Bone Loss in Patients with Acute Spinal Cord Injury: A Randomized, Double-Blind, Placebo-Controlled Study

Abstract

We conclude that alendronate therapy, 70 mg/wk, initiated soon after acute SCI, prevents bone loss and is not associated with side effects.

A Rare Cause of Hypercalcemia: “Immobilization” A Case Report and Literature Review

“…If intravenous saline (with or without furosemide) fails to control hypercalcemia, a second line of medications is usually is needed [15][16][17]. When the hypercalcemia is severe, initial administration of calcitonin can be used.…”

Zoledronic acid improves bone mineral density in pediatric spinal cord injury

“…As noted, bisphosphonate therapy in adult SCI has met with very limited success. (10,(12)(13)(14)(15)(16) Using the inherent anabolic effect of growth in children, bisphosphonate therapy in the pediatric age group has the potential to influence the retention of primary trabecular bone and affect cortical modeling through the prevention of endocortical bone resorption. Although the positive effects of bisphosphonate therapy had been shown in children with osteogenesis imperfecta and secondary causes of osteoporosis, the benefit in children with flaccid paralysis had not been previously reported.…”

“…(10) Hence bisphosphonates have been used for more than two decades in the treatment of SCI-induced osteoporosis in adult patients. (11) However, studies with different bisphosphonates (12)(13)(14)(15) produced inconsistent results with the majority showing mild attenuation of bone density loss and effects that were not always sustained during follow-up. Most were small studies with 12 months duration and none addressed the issue of fracture outcome in treated patients.…”

Physiatrists' opinions and practice patterns for bone health after SCI

“…There is some evidence to suggest that pharmacological therapy is beneficial for bone health after SCI, [15][16][17][18][19][20] nonetheless, we recognize that more specific guidelines are necessary. Although there is some literature to support the use of bisphosphonates, we note that Bauman et al 19 found a small beneficial effect in total leg bone mineral density by DXA in the first month that was not maintained at 12 months.…”

“…Although there is some literature to support the use of bisphosphonates, we note that Bauman et al 19 found a small beneficial effect in total leg bone mineral density by DXA in the first month that was not maintained at 12 months. More recently however, Gilchrist et al 20 reported maintenance of femoral neck BMD by DXA at 1 year with alendronate that was commenced on average 10 days after injury. More research is necessary to determine the longterm consequences of treatment, including the effect on fracture end point.…”