Background It is noticed that spinal cord injury (SPI) is a difficult process associated to patient immobilization which leads to bone mass decrease, osteoporosis risk and high risk of bone fracture. In these patients a low bone mass and bone resorption is observed, even in the six months after SPI, and this situation stabilizes over the next 22–26 months after injury. Moreover there is an increased bone fracture risk due to the high risk of osteoporosis.
Objectives To assess bone metabolism and bone fracture incidence in SPI patients.
Methods Prospective study of SPI patients from the Spinal Cord Injury Unit of La Fe Hospital. In all cases lower backs and hips densitometry, spinal cord plain x-ray image, bone metabolism biomarkers and clinical evaluation have been performed. Statistical techniques was carried out using R software 3.2.3.
Results We studied 37 patients with SCI, 46% of them women, with a mean age at SPI of 54.38±24.77 years. The 58.9% of patients showed thoracic injuries, 48.6% paraparesis and 46.7% presented level C in Asia scale. Results from biochemical markers of bone turnover and densitometry are showed in the table.
We observed a statistically association between decreased vitamin D values and increased values of bCTX (P=0.002) and PTH (P=0.03). In addition, altered PTH and vit D values are associated with thoracic location of the SCI (P=0.03), total loss of mobility (P=0.02) and high levels in Asia Scale (P=0.004). Also, classic osteoporosis risk factors were evaluated, and they were significantly and inversely related to alcohol consumption (P=0,022), frequent falls in the last year (P=0.02), long-term use of anticoagulants (P=0.006), and altered values of PTH and vitamin D.
Conclusions A high proportion of our SCI patients showed serum vitamin D deficit, associated to high levels of bCTX and PTH. Moreover, patients with the lowest vitamin D levels were more likely to have higher limitation of movement and higher Asia Scale levels.
Disclosure of Interest None declared
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