Literature DB >> 24096543

Incidence of skeletal fractures after traumatic spinal cord injury: a 10-year follow-up study.

Laia Gifre1, Joan Vidal, Josep Carrasco, Enric Portell, Josep Puig, Ana Monegal, Núria Guañabens, Pilar Peris.   

Abstract

OBJECTIVE: To analyse the incidence and factors related to the development and clinical evolution of fractures in patients with traumatic spinal cord injury.
DESIGN: A retrospective 10-year follow-up study.
SETTING: Neurorehabilitation centre.
SUBJECTS: Sixty-three patients (50M/13F) with a mean age of 36 ± 20 years with recent traumatic spinal cord injury attended over a one-year period (January to December 2000). MAIN MEASURES: Medical reports were reviewed, evaluating risk factors for osteoporosis, fracture incidence during the 10 years following spinal cord injury, severity (ASIA score) and level of spinal cord injury (paraplegia/tetraplegia), type of lesion (spastic/flaccid), weight-bearing standing activity, and the cause, location and evolution of the fracture.
RESULTS: Of the 129 patients attending during the study period, 75 had traumatic spinal cord injury (7 died and 5 had no follow-up). Finally, 63 patients were included. Fifty-four per cent had complete motor injury (ASIA A). Twenty-five per cent of these patients developed fractures, with 2.9 fractures per 100 patient-years. The femur was the most frequent location of the fractures. Fractures were observed 6.4 ± 2.4 years after spinal cord injury (range 2-10 years), all in males. Most fractures (70%) were related to low-impact injuries. Fifty per cent presented with associated clinical complications and only 20% of the patients had received anti-osteoporotic treatment. Spinal cord injury severity was the only risk factor for the development of fractures (complete spinal cord injury (ASIA A)) (RR 4.043; 95% confidence interval (CI) 1.081-23.846, P = 0.037).
CONCLUSION: The incidence of fractures after spinal cord injury is high, with severity and time since spinal cord injury being the main determinants for their development. Fractures were frequently associated with clinical complications. However, the use of anti-osteoporotic treatment was uncommon.

Entities:  

Keywords:  ASIA; Fractures; incidence; paraplegia; risk factors; spinal cord injury

Mesh:

Substances:

Year:  2013        PMID: 24096543     DOI: 10.1177/0269215513501905

Source DB:  PubMed          Journal:  Clin Rehabil        ISSN: 0269-2155            Impact factor:   3.477


  30 in total

Review 1.  Bone Imaging and Fracture Risk after Spinal Cord Injury.

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2.  Risk factors for the development of osteoporosis after spinal cord injury. A 12-month follow-up study.

Authors:  L Gifre; J Vidal; J L Carrasco; A Muxi; E Portell; A Monegal; N Guañabens; P Peris
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3.  Precision of dual-energy X-ray absorptiometry of the knee and heel: methodology and implications for research to reduce bone mineral loss after spinal cord injury.

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Review 4.  Bone loss at the distal femur and proximal tibia in persons with spinal cord injury: imaging approaches, risk of fracture, and potential treatment options.

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5.  Dual-energy X-ray absorptiometry and fracture prediction in patients with spinal cord injuries and disorders.

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6.  Investigating comparability of quantitative computed tomography with dual energy x-ray absorptiometry in assessing bone mineral density of patients with chronic spinal cord injury.

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7.  Risk factors for osteoporotic fractures in persons with spinal cord injuries and disorders.

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8.  Whole-body vibration can attenuate the deterioration of bone mass and trabecular bone microstructure in rats with spinal cord injury.

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9.  Denosumab increases sublesional bone mass in osteoporotic individuals with recent spinal cord injury.

Authors:  L Gifre; J Vidal; J L Carrasco; A Muxi; E Portell; A Monegal; N Guañabens; P Peris
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10.  Open-label clinical trial of alendronate after teriparatide therapy in people with spinal cord injury and low bone mineral density.

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