Osteoporosis after spinal cord injury

Immobilisation secondary to spinal cord injury (SCI) is associated with mar ked and rapid atrophy of trabecular bone. The purpose of this study was to evaluate bone mineral density (BMD) in both the upper and lower extremities following SCI sustained for various lengths of time and to correlate the B MD to the level of the lesion, time from injury, spasticity and serum calci um, phosphorus and alkaline phosphatase (ALP) levels. A study was undertake n in 41 SCI patients with a mean age of 35.8 +/- 12.7 years. A significant difference in BMD between upper and lower extremities of the paraplegics we re found. BMD of upper and lower extremities were similar in tetraplegics. The BMD values were significantly different when the upper extremity scores of paraplegics and tetraplegics were compared but BMD scores of the lower extremities were similar in the two groups. The decrease in BMD was less in the spastic patients when compared to the flaccid group. There was a posit ive correlation between time from injury and the degree of BMD deficit in t he paralysed areas. In the whole group of patients in significant positive correlation was found between the duration of SCI and serum ALP levels.