S1 Guidelines on Bone Impairment in Spinal Cord Injury

Dionyssiotis, Yannis; Kalke, Yorck-Bernhard; Frotzler, Angela; Moosburger, J.; Trovas, George; Kaskani, Evangelia; Erhan, Belgin; Foti, Calogero; Papathanasiou, Jannis; Ferretti, J.L.; Imamura, Marta; Rapidi, Anastasia-Christina; Bone, HeSCOSPRM

doi:10.1016/j.jocd.2021.03.009

Cited by 10 publications

(10 citation statements)

References 68 publications

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“…Based on current evidence, various bisphosphonates, including oral etidronate and intravenous zoledronate, have shown e cacy in slowing BMD decline in the hip and knee region [28][29][30][31] . Nevertheless, no de nite pharmacologic guidelines for reducing the actual fracture risk in SCI have been set 32,33 , and further research should propose enhanced evidence-based preventative measures in which the fracture itself is an endpoint.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Bone Loss and Associated Risk Factors in Men with Spinal Cord Injury and Community-dwelling Adults

Kim

Hong

Shin³

2023

Preprint

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Study Design: retrospective chart audit Objectives: In individuals with spinal cord injury (SCI), bone loss proceeds rapidly to the area below the level of injury, leading to increased risk of fracture. However, there are limited data on the degree of bone loss in individuals with SCI and associated factors in comparison with community-dwelling adults. Settings: rehabilitation center in Seoul, Republic of Korea; community in Republic of Korea Methods: Data from men with SCI who underwent Dual-energy X-ray Absorptiometry at the National Rehabilitation Center (2008 to 2020) between 12 and 36 months after injury were analyzed. Data from community-dwelling men in the Korea National Health and Nutrition Examination Survey (KNHANES, 2008–2011) were 1:1 matched for age, height, and weight as the control group. Results: Among 226 men (SCI, n = 113; control, n = 113), femoral neck (-1.9 versus [vs.] -0.6) and total hip T-scores (-1.6 vs. -0.1; all, p <0.001) were significantly lower in the SCI group than in the KNHANES group, whereas the lumbar spine T-score did not differ between groups (-1.1 vs. -0.8, p = 0.105). The group difference in the femoral neck T-score remained significant after adjustment for covariates (adjusted β: -1.27, vs. KNHANES, p<0.001). Among men with SCI, low body mass index and cervical level of injury (vs. thoracolumbar level) were negatively correlated with femoral neck bone mineral density. Conclusions: Men with SCI had lower femoral neck and total hip T-score than community-dwelling men, independent of age, BMI, and other covariates.

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Section: Discussionmentioning

confidence: 99%

Comparison of Bone Loss and Associated Risk Factors in Men with Spinal Cord Injury and Community-dwelling Adults

Kim

Hong

Shin³

2023

Preprint

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“…SCI is mainly divided into primary injury and secondary injury. The primary injury is often irreversible, the current treatment is mainly depending on prevention and treatment of secondary SCI 4,5 . Traditional Chinese medicine has been believed to present potential effectiveness for the treatment of nervous system diseases including SCI.…”

Section: Introductionmentioning

confidence: 99%

“…The primary injury is often irreversible, the current treatment is mainly depending on prevention and treatment of secondary SCI. 4 , 5 Traditional Chinese medicine has been believed to present potential effectiveness for the treatment of nervous system diseases including SCI. Buyang Huanwu Decoction (BYHWD) comprised seven medicinal herbs, including Raw Astragalus, Angelica, Earthworm, Red peony, Ligusticum chuanxiong , Peach kernel, and Safflower.…”

Section: Introductionmentioning

confidence: 99%

Buyang Huanwu Decoction promotes the neurological recovery of traumatic spinal cord injury via inhibiting apoptosis, inflammation, and oxidative stress

Xu¹,

Song²,

Yang³

et al. 2023

Immunity Inflam & Disease

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Background The incidence rate of spinal cord injury (SCI) is increasing, and the mortality or disability rate caused by SCI remains high in the world. Buyang Huanwu Decoction (BYHWD) is a kind of Traditional Chinese medicine, and it is believed to be effective in several kinds of nervous system diseases. Whether BYHWD could improve SCI and the potential function mechanism remain unclear. Methods SCI animal model was established by damaging T10 spinal cord. Animals experiments included five groups as follows: Sham, SCI, SCI+BYHWD, SCI+mesenchymal stromal cells (MSCs), and SCI+BYHWD+MSCs. H2O2‐treated cells (100 µM, 6 h) were used to simulate SCI damage in vitro, which included five groups as follows: control, H2O2, H2O2+BYHWD, H2O2+MSCs, and H2O2+BYHWD+MSCs. The behavioral function was evaluated with Tarlov and inclined plated test score. Western blot analysis and immunohistochemical staining were used to detect protein expression. The levels of superoxide dismutase (SOD), catalase (CAT), malondiadehyde (MDA), interleukin (IL)‐1β, tumor necrosis factor‐α, and IL‐6 in serum were measured with commercial enzyme‐linked immunosorbent assay kits. terminal deoxynucleotidyl transferase dUTP nick end labeling staining and flow cytometry were performed to measure apoptosis in vivo and in vitro levels. Gene expression profiling analysis was performed to analyze differential expression genes. Results BYHWD suppressed apoptosis and accelerating cell proliferation after SCI. Recovery of neurofunction, inhibition of inflammatory response, and oxidative condition were achieved by BYHWD and MSCs. The expression levels of gp130/Janus kinase/signal transducers and activator of transcription (JAK/STAT) were suppressed by BYHWD and MSCs, both in vivo and in vitro. BYHWD and MSCs markedly promoted cells viability and inhibited apoptosis. Greater gene expression difference was observed between group control and H2O2 through gene expression profiling analysis. The recovery effects of traumatic SCI by BYHWD were similar to MSCs, and synergies effects were observed in several items. Conclusion BYHWD could increase Tarlov score and Basso, Beatie, and Bresnahan functional score, inhibit apoptosis, inflammatory response, and oxidative condition after SCI. The expression level of gp130/JAK/STAT axis was suppressed by BYHWD. BYHWD might be a new therapeutic strategy for the prevention or treatment of SCI.

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“…Bone formation, regeneration and degradation processes are stimulated by mechanical strain as a result of applied mechanical stress in the form of muscular contraction, impact loading and gravitational forces (Kini and Nandeesh, 2012). Bone loss due to mechanical unload occurs for example in some types of physical impairment like spinal cord injury (SCI) and lower limb amputation (LLA) (Sherk et al, 2008;Dionyssiotis et al, 2021). In SCI the greatest amount of bone loss takes place in the first 2 years after injury, after that bone loss occurs gradually and bone formation is inhibited (Ragnarsson and Sell, 1981;Demirel et al, 1998;Dauty et al, 2000;Eser et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Sporting activity does not fully prevent bone demineralization at the impaired hip in athletes with amputation

Cavedon

Sandri²,

Peluso³

et al. 2022

Front. Physiol.

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There is lack of information about bone mineralization at the lumbar spine and bilateral hips of athletes with unilateral lower limb amputation. The present study assessed for the first time the areal bone mineral density at the lumbar spine and at the hip of the able and impaired leg by means of Dual-Energy X-Ray Absorptiometry using a large sample (N = 40) of male athletes. Results showed that bone demineralization in athletes with unilateral lower limb amputation is found at the impaired hip but not at the lumbar spine and may therefore be site-specific. The extent of hip demineralization was influenced by the level of amputation, with about 80% of athletes with above knee amputation and 10% of athletes with below knee amputation showing areal bone mineral density below the expected range for age. Nevertheless, a reduced percentage of fat mass and a lower fat-to-lean mass ratio in the residual impaired leg as well as a greater amount of weekly training was positively associated with bone mineralization at the impaired hip (partial correlation coefficients = 0.377–0.525, p = 0.040–0.003). Results showed that participation in adapted sport has a positive effect on bone health in athletes with unilateral lower limb amputation but is not sufficient to maintain adequate levels of bone mineralization at the impaired hip in athletes with above-knee amputation. Accordingly, physical conditioners should consider implementing sporting programs, according to the severity of the impairment, aimed at improving bone mineralization at the impaired hip and improve body composition in the residual impaired leg.

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S1 Guidelines on Bone Impairment in Spinal Cord Injury

Cited by 10 publications

References 68 publications

Comparison of Bone Loss and Associated Risk Factors in Men with Spinal Cord Injury and Community-dwelling Adults

Comparison of Bone Loss and Associated Risk Factors in Men with Spinal Cord Injury and Community-dwelling Adults

Buyang Huanwu Decoction promotes the neurological recovery of traumatic spinal cord injury via inhibiting apoptosis, inflammation, and oxidative stress

Sporting activity does not fully prevent bone demineralization at the impaired hip in athletes with amputation

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