Background The spinal cord injury associated with the immobilization of the patient leads to a decrease in bone mass. The bone loss greater is observed in the 6 months after the spinal cord injury, and stabilizing between 12–16 months after the same. The incidence of fractures oscillates between 1.5% and 6%.
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 densitometry, x-ray image, bone metabolism biomarkers and clinical evaluation have been performed according protocol. Statistical techniques was carried out using R software 3.2.3, using mixed linear regression models.
Results We studied 40 patients with SCI, 54% of them men and 46% women, with a mean age of 59.5 years (57.3- 63.5). The 58% of patients showed thoracic injuries, 48.6% paraparesis and 46.7% presented level C in Asia scale. The baseline study was performed in 100% of patients (n=40), 65% in month 6 (n=26), 30% in month 12 (n=12), and in 22.5% in month 18 (n=9). The 32.4% of patients received supplementation with calcium and vitamin D at month 0, 66.7% at month 6 and 100% at month 12.
In month 6, the 11.1% was treated with antiresorptive drugs.
An increase in vitamin D values can be observed in the population with follow-up (values of 16.82 in month 0 to 39.33 in month 12), justified by the supplementation, and there is an increase in Calcium and a decrease in phosphorum values.
There was also a decrease in PTH levels in month 12 (32.3) compared to month 0 (34.08), as well as a decrease in bctx levels. Probably related to the increase of vitamin D.
Despite a decrease in the densitometric parameters at month 6, a slight recovery in bone mineral density at month 12 was observed. No bone fractures were seen during Follow-up in none of the patients.
Results from biochemical markers and densitometry are showed in the table
Conclusions A high percentage of our patients with spinal cord injury has a vitamin D deficiency. In addition, the lower levels are associated with cases where the mobility limitation is higher. As patients increase vitamin D values, a decrease in the bctx and PTH parameters is observed.
No fractures were detected during follow-up.
Disclosure of Interest None declared
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