CYCLICAL ETIDRONATE - ITS EFFECT ON BONE-DENSITY IN PATIENTS WITH ACUTE SPINAL-CORD INJURY

Objective: To compare the effects of a 30-week trial of cyclical etidr onate therapy (starting within 6 weeks of spinal cord injury [SCI]) an d conventional rehabilitation without etidronate treatment on the bone density of the lumbar spine and lower extremities of SCI patients. De sign: Prospective, randomized control trial. Setting: Tertiary care, i npatient rehabilitation center. Patients: Acute SCI, within 6 weeks of injury. Thirteen SCI subjects were recruited; 6 were assigned randoml y to receive etidronate and 7 to receive conventional treatment. Inter vention: Etidronate, 800mg orally, once per day for 2 weeks of 15 week s, repeated once. Main Outcome Measures: Dual x-ray absorptiometry of the spine, hip, distal femur, and proximal tibia measured at baseline, 6 months, and 12 months. Results: A significant interaction between e tidronate treatment and ambulatory status over time was observed in th e bone density of the patients after SCI (p = .0003). The patients who became ambulatory and received etidronate treatment had a preservatio n of bone density as compared to all other patients who showed a loss of bone density over time. The loss of bone density occurred in the le g bones, not the spine. Cyclical etidronate treatment was tolerated we ll without adverse or side effects. Conclusion: Cyclical etidronate is a feasible treatment and may prevent osteoporosis associated with SCI in patients who eventually walk. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.