Evaluating Bone Loss with Bone Turnover Markers Following Acute Spinal Cord Injury

Abstract

To evaluate bone turnover markers (BTMs) in individuals with acute spinal cord injury (SCI) and to compare the results with those of healthy controls and postmenopausal females. Overview of Literature: SCI significantly impacts bone health. Change in bone mineral density appears 6 months after SCI and rapid bone loss during the acute phase is often underestimated, resulting in osteoporosis and a high risk of sublesional fractures. However, few studies have evaluated BTMs in the Indian SCI population. Despite a high risk of fracture, there are no guidelines for the diagnosis, monitoring, and management of SCI-induced osteoporosis. Methods: Twenty patients within 1 month of traumatic SCI who had been admitted to a tertiary care rehabilitation center were included in this study. Serum BTMs, C telopeptide (CTX) as a bone resorption marker, and osteocalcin as a bone formation marker, were serially measured at baseline, and 3 and 6 months after SCI. BTMs of SCI patients were compared with those of a control group of age-matched healthy males, premenopausal females, and a vulnerable group of postmenopausal females. Results: BTMs were significantly elevated in patients with SCI, with maximum levels observed at the 3rd month of injury. At baseline, the bone resorption marker CTX was approximately 3 times higher in SCI patients than in the control male population and premenopausal females, and about double that of postmenopausal females. The rise in the bone formation marker was marginal in comparison to that of the bone resorption marker. BTMs were persistently elevated and did not reach the normative range until the 6th month of SCI. Conclusions: Raised bone resorption markers in comparison to bone formation markers indicate hyper-resorption-related bone loss following acute SCI. Markedly elevated bone resorption markers in the SCI population, compared with those in control and vulnerable groups, emphasize the need for early bone health monitoring and management.

Effect of lumbar spinal stenosis on bone mineral density in osteoporosis patients treated with ibandronate

“…In patients with LSS, a decrease in the therapeutic effect of ibandronate may also be associated with deterioration of bone metabolism [ 24 ]. Lee et al [ 14 ] reported that 55.6 % of patients with LSS had hypovitaminosis D, which reduced the effectiveness of osteoporosis treatment.…”

Effect of Lumbar Spinal Stenosis on Bone Mineral Density in Osteoporosis Patients Treated With Ibandronate

“…In patients with LSS, a decrease in the therapeutic effect of ibandronate may also be associated with deterioration of bone metabolism [24]. Lee et al [14] reported that 55.6% of patients with LSS had hypovitaminosis D, which reduced the effectiveness of osteoporosis treatment.…”

Osteoporosis Etiology, Epidemiology, Diagnosis, Diet, and Treatment: A Narrative Review

“…Ankylosing spondylitis [99], RA [100], SLE [101] Neurological and musculoskeletal risk factors Epilepsy [102,103], Multiple sclerosis [104], Muscular dystrophy [105], Parkinson's disease [106], Spinal cord injury [107,108], Stroke [109] Miscellaneous conditions and diseases Addiction to narcotics [110], AIDS/HIV [111,112], Amyloidosis [113], Chronic metabolic acidosis, COPD [114], CHF [115], Endstage renal disease [116], Hypercalciuria [117], Idiopathic scoliosis [118], post-transplant bone disease [119], Socioeconomic status [120], Sarcoidosis [121], Weight loss [122] Long-term calcium intake is essential in building bone reserves before the PBM level and maintaining bone mass later at age twenty. The risk of secondary OP can be initiated by calcium deficiency [123] or lack of absorption [124].…”