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osteoporosis and spinal cord injury

Martin H Pham, Zorica Buser, Jeffrey C Wang, Frank L Acosta
Animal and human studies demonstrate the anabolic properties of low-magnitude mechanical stimulation (LMMS) in its ability to improve bone formation by enhancing the proliferation of mesenchymal stem cells and their subsequent commitment down an osteoblastic lineage. Response to mechanical strains as low as 10μɛ have been seen, illustrating the sensitivity of mechanosensory cells to mechanotransduction pathways. Applications to the spine include treatment of osteoporosis in preparation for instrumented fusion, fracture reduction in spinal cord injury patients to slow bone mineral density loss, and bone tissue engineering and enhancement of bone-implant osseointegration for pseudarthrosis and hardware failure...
January 12, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Brian Andrews, James Shippen, Monica Armengol, Robin Gibbons, William Holderbaum, William Harwin
FES assisted activities such as standing, walking, cycling and rowing induce forces within the leg bones and have been proposed to reduce osteoporosis in spinal cord injury (SCI). However, details of the applied mechanical stimulus for osteogenesis is often not reported. Typically, comparisons of bone density results are made after costly and time consuming clinical trials. These studies have produced inconsistent results and are subject to sample size variations. Here we propose a design process that may be used to predict the clinical outcome based on biomechanical simulation and mechano-biology...
September 15, 2016: European Journal of Translational Myology
L Abderhalden, F M Weaver, M Bethel, H Demirtas, S Burns, J Svircev, H Hoenig, K Lyles, S Miskevics, L D Carbone
: Low T-scores at the hip predict incident fractures in persons with a SCI. INTRODUCTION: Persons with a spinal cord injury (SCI) have substantial morbidity and mortality following osteoporotic fractures. The objective of this study was to determine whether dual-energy X-ray absorptiometry (DXA) measurements predict osteoporotic fractures in this population. METHODS: A retrospective historical analysis that includes patients (n = 552) with a SCI of at least 2 years duration who had a DXA performed and were in the VA Spinal Cord Disorders Registry from fiscal year (FY) 2002-2012 was performed...
December 6, 2016: Osteoporosis International
C M Cirnigliaro, M J Myslinski, M F La Fountaine, S C Kirshblum, G F Forrest, W A Bauman
Persons with spinal cord injury (SCI) undergo immediate unloading of the skeleton and, as a result, have severe bone loss below the level of lesion associated with increased risk of long-bone fractures. The pattern of bone loss in individuals with SCI differs from other forms of secondary osteoporosis because the skeleton above the level of lesion remains unaffected, while marked bone loss occurs in the regions of neurological impairment. Striking demineralization of the trabecular epiphyses of the distal femur (supracondylar) and proximal tibia occurs, with the knee region being highly vulnerable to fracture because many accidents occur while sitting in a wheelchair, making the knee region the first point of contact to any applied force...
December 5, 2016: Osteoporosis International
Hai-Juan Liu, Hua Yan, Jun Yan, Hao Li, Liang Chen, Li-Ren Han, Xiao-Fei Yang
Spinal cord injury (SCI) causes a significant amount of bone loss, which results in osteoporosis (OP). The neuropeptide substance P (SP) and SP receptors may play important roles in the pathogenesis of OP after SCI. To identify the roles of SP in the bone marrow mesenchymal stem cell derived osteoblasts (BMSC-OB) in SCI rats, we investigated the expression of neurokinin-1 receptors (NK1R) in BMSC-OB and the effects of SP on bone formation by development of BMSC-OB cultures. Sixty young male Sprague-Dawley rats were randomized into two groups: SHAM and SCI...
2016: PloS One
X Yang, D Hao, H Zhang, B Liu, M Yang, B He
: Treatment with hydrogen sulfide mitigates spinal cord injury-induced sublesional bone loss, possibly through abating oxidative stress, suppressing MMP activity, and activating Wnt/β-catenin signaling. INTRODUCTION: Spinal cord injury (SCI)-induced sublesional bone loss represents the most severe osteoporosis and is resistant to available treatments to data. The present study was undertaken to explore the therapeutic potential of hydrogen sulfide (H2S) against osteoporosis in a rodent model of motor complete SCI...
September 3, 2016: Osteoporosis International
L R Morse, N Nguyen, R A Battaglino, A J Guarino, D R Gagnon, R Zafonte, E Garshick
: We identified a protective bone effect at the knee with lipophilic statin use in individuals with chronic spinal cord injury. Lipophilic statin users gained bone at the knee compared to non-users and wheelchair users lost bone compared to walkers. Ambulation and or statins may be effective osteogenic interventions in chronic spinal cord injury (SCI). INTRODUCTION: SCI increases the risk of osteoporosis and low-impact fractures, particularly at the knee. However, during the chronic phase of SCI, the natural history and factors associated with longitudinal change in bone density remain poorly characterized...
July 13, 2016: Osteoporosis International
Antonio Leone, Marzia Marino, Claudia Dell'Atti, Viola Zecchi, Nicola Magarelli, Cesare Colosimo
The ankylosed spine is prone to fracture even after minor trauma due to its changed biomechanical properties. The two central features of ankylosing spondylitis (AS) that promote the pathological remodeling of the spine are inflammation and new bone formation. AS is also associated with osteoporosis that is attributed to an uncoupling of the bone formation and bone resorption processes. Therefore, bone resorption occurs and promotes weakening of the spine as well as increased risk of vertebral fractures which can be hugely different in terms of clinical relevance...
October 2016: Rheumatology International
Eziamaka C Okafor, Rajiv Gupta, David Estrada, J Andrew Taylor, Can Ozan Tan
No abstract text is available yet for this article.
May 2016: Medicine and Science in Sports and Exercise
DA-An Zhou, Yue Ning Deng, Lei Liu, Jian Jun Li
The present study aimed to investigate the effect of traditional Chinese kidney reinforcing and marrow-beneficial medicine (KRMB) on the prevention and treatment of abnormal bone metabolism and osteoporosis (OP) resulting from spinal cord injury (SCI). Rat models of OP following SCI were surgically established. The rats were randomly divided into five groups: Normal; sham operation + KRMB; normal + KRMB; SCI + KRMB; and SCI model group. Bone mineral density (BMD), and the expression of bone gamma-carboxyglutamic-acid containing protein (BGP), hepcidin mRNA and bone sialoprotein (BSP) were recorded at 1, 2, 4, 6, 8 and 10 weeks after the operation...
July 2016: Experimental and Therapeutic Medicine
F Kandziora, P Schleicher, K J Schnake, M Reinhold, B Aarabi, C Bellabarba, J Chapman, M Dvorak, M Fehlings, R Grossman, C K Kepler, C Öner, R Shanmuganathan, L R Vialle, A R Vaccaro
Optimal treatment of injuries to the thoracolumbar spine is based on a detailed analysis of instability, as indicated by injury morphology and neurological status, together with significant modifying factors. A classification system helps to structure this analysis and should also provide guidance for treatment. Existing classification systems, such as the Magerl classification, are complex and do not include the neurological status, while the TLICS system has been accused of over-simplifying the influence of fracture morphology and instability...
February 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Khalil Ahmad, Sumeera Matee, Saeed Bin Ayaz, Hussain Rashid Ihsan
PURPOSE: Ankylosing spondylitis affects the axial skeleton over many years, predisposing to osteoporosis and subsequent fractures. However, very rarely, it can be incidentally discovered in spinal cord injury cases. CASE REPORT: A 44-year-old male veteran who had previously been well and asymptomatic presented with paraparesis secondary to fractured dorsal vertebrae 10 and 11, following fall from a height. He had been referred to our institute for rehabilitation after surgical fixation of his vertebral fractures...
September 2015: Acta Neurologica Taiwanica
Dragana Kljajić, Fadilj Eminović, Milivoj Dopsaj, Dragan Pavlović, Sladjana Arsić, Jadranka Otašević
OBJECTIVES: Studying the quality of life of people with a spinal cord injury is of great importance as it allows the monitoring of both functioning and adaptation to disability. The aim of this study was to determine the difference between persons with a spinal cord injury involved in sports activities and those not involved in sports activities in relation to their quality of life and the presence of secondary health conditions (pressure ulcers, urinary infections, muscle spasms, osteoporosis, pain, kidney problems-infections, calculosis and poor circulation)...
June 1, 2016: Zdravstveno Varstvo
L M Giangregorio, J C Gibbs, B C Craven
Peripheral quantitative computed tomography (pQCT) can be used to examine bone strength outcomes and muscle size and fatty infiltration. Our research team and others have used it to examine bone loss after spinal cord injury (SCI). However, the high prevalence of restricted lower extremity range of motion, spasticity, edema, excessive muscle atrophy, or severe osteoporosis necessitates changes to standard protocols for screening, positioning during scan acquisition, and analysis methods. This manuscript outlines the challenges that we experienced using pQCT in individuals with SCI, and provides solutions, ones that may also be applicable when using pQCT in individuals with other chronic conditions or in older adults...
August 2016: Osteoporosis International
Farideh A Javid, Roger M Phillips, S Afshinjavid, Roberta Verde, Alessia Ligresti
Cannabinoids have been used for many centuries to ease pain and in the past decade, the endocannabinoid system has been implicated in a number of pathophysiological conditions, such as mood and anxiety disorders, movement disorders such as Parkinson's and Huntington's disease, neuropathic pain, multiple sclerosis, spinal cord injury, atherosclerosis, myocardial infarction, stroke, hypertension, glaucoma, obesity, and osteoporosis. Several studies have demonstrated that cannabinoids also have anti-cancer activity and as cannabinoids are usually well tolerated and do not produce the typical toxic effects of conventional chemotherapies, there is considerable merit in the development of cannabinoids as potential anticancer therapies...
March 15, 2016: European Journal of Pharmacology
Min Liu, Xianping Wu, Min Tong, Xiyu Wu, Jinping Zhou
STUDY DESIGN: Seventy-five SD rats were randomly assigned to four groups: sham-operated group (Sham, n = 15), complete spinal cord transection (CSCT, n = 20) group, hyperbaric oxygenation group 1 (HBO1, n = 20), and hyperbaric oxygenation group 2 (HBO2, n = 20). OBJECTIVE: The aim of this study was to analyze the impacts of ultra-early hyperbaric oxygen therapy on bone mass of rats with CSCT. SUMMARY OF BACKGROUND DATA: Treatment of patients with complete SCI is still an unresolved medical issue and needs to be further investigated...
July 15, 2016: Spine
Karen L Troy, Leslie R Morse
BACKGROUND: Spinal cord injury (SCI) is associated with a rapid loss of bone mass, resulting in severe osteoporosis and a 5- to 23-fold increase in fracture risk. Despite the seriousness of fractures in SCI, there are multiple barriers to osteoporosis diagnosis and wide variations in treatment practices for SCI-induced osteoporosis. METHODS: We review the biological and structural changes that are known to occur in bone after SCI in the context of promoting future research to prevent or reduce risk of fracture in this population...
2015: Topics in Spinal Cord Injury Rehabilitation
Tiao Lin, Wei Tong, Abhishek Chandra, Shao-Yun Hsu, Haoruo Jia, Ji Zhu, Wei-Ju Tseng, Michael A Levine, Yejia Zhang, Shi-Gui Yan, X Sherry Liu, Dongming Sun, Wise Young, Ling Qin
Spinal cord injury (SCI)-induced bone loss represents the most severe osteoporosis with no effective treatment. Past animal studies have focused primarily on long bones at the acute stage using adolescent rodents. To mimic chronic SCI in human patients, we performed a comprehensive analysis of long-term structural and mechanical changes in axial and appendicular bones in adult rats after SCI. In this experiment, 4-month-old Fischer 344 male rats received a clinically relevant T13 contusion injury. Sixteen weeks later, sublesional femurs, tibiae, and L4 vertebrae, supralesional humeri, and blood were collected from these rats and additional non-surgery rats for micro-computed tomography (µCT), micro-finite element, histology, and serum biochemical analyses...
2015: Bone Research
Tejal Patel, Jamie Milligan, Joseph Lee
OBJECTIVE: To determine the frequency of medical problems, reason for referral/primary complaint, products used, medication-related problems, and polypharmacy in patients with spinal cord injury (SCI) seen at an interprofessional primary care mobility clinic. DESIGN: Retrospective review of medical records of patients with SCI for patient visits between August 2012 and March 2013. METHODS: Data were abstracted from medical records of patients with SCI...
April 8, 2016: Journal of Spinal Cord Medicine
Renato Varoto, Alberto Cliquet
Cybernetics-based concepts can allow for complete independence for paralyzed individuals, including sensory motor recovery. Spinal cord injuries are responsible for a huge stress on health and a financial burden to society. This article focuses on novel procedures such as functional diagnosis for paraplegics and tetraplegics, cybertherapies toward lessening comorbidities such as cardiovascular diseases, osteoporosis, etc., and the production of new technology for upper and lower limb control. Functional electrical stimulation reflects a unique opportunity for bipedal gait to be achieved by paraplegics and tetraplegics...
October 2015: Artificial Organs
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