Treatment of osteoporosis in patients with spinal cord injury
Background. Osteoporosis is a well-known complication of spinal cord injury (SCI). Significance of this problem grows proportionally to the social adaptation of para- and tetraplegic patients. The purpose of the study was to evaluate the effectiveness of the combined treatment for SCI-induced osteoporosis. Materials and methods. Twenty-nine male patients with SCI (AIS A, B) with a duration of post-traumatic period at least 12 months were examined, 17 of whom received comprehensive treatment with calcium, vitamin D and ibandronic acid (group I), and 12 patients, who did not received the prescribed treatment for various reasons (group II). The bone mineral density (BMD) was determined at the total body, lumbar spine and total hip twice (before treatment and 12 months later) by X-ray absorptiometry (X-ray densitometry), which was performed on Prodigy (GE, 2005). Results. It was shown a significant reduction in BMD at the level of total body — by 3.7 % (1.111 ± 0.023 versus 1.005 ± 0.031 g/cm2, respectively; p < 0.05), total hip — by 11.6 % (0.852 ± 0.018 versus 0.756 ± 0.023 g/cm2, respectively; p < 0.05) and lower extremities — by 10.2 % (1.193 ± 0.019 versus 1.061 ± 0.027 g/cm2, respectively; p < 0.05) in patients of group II, who did not receive treatment. BMD in regions of the skeleton located below the level of trauma was stabilized, and BMD at the level of the lumbar spine was significantly increased by 5.6 % (1.097 ± 0.022 versus 1.158 ± 0.019 g/cm2, respectively; p < 0.05) in group I as a result of the treatment. Conclusions. The comprehensive therapy in patients with SCI-induced osteoporosis made it possible to reduce the loss of BMD of the lower extremities and the risk of fractures due to low-energy trauma that can improve the rehabilitation possibilities and quality of life in patients with SCI. The proposed method for treating SCI-induced osteoporosis is effective and safe, which allows it to be recommended for use in clinical practice.
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