Bone Health following Spinal Cord Injury: A Clinical Guide to Assessment and Management

Phys Med Rehabil Clin N Am. 2025 Feb;36(1):99-110. doi: 10.1016/j.pmr.2024.07.007. Epub 2024 Sep 7.

Abstract

A marked decrease in bone mineral density is a well recognized, if not always fully addressed, spinal cord injury-related comorbidity. The bone loss starts shortly after paralysis onset, and the loss rate is steep. The diverse etiology includes mechanical, neurologic, endocrine, vascular, and pharmacologic factors. Dual x-ray absorptiometry is available and affordable to quantify the degree of bone loss and follow changes related to treatment. Fragility/low impact fractures occur frequently and can induce significant morbidity. Physical modalities and pharmacologic interventions can be employed to stave off and/or reverse bone loss with variable success rates.

Keywords: Bone mass; Bone mineral density; DXA; Fracture; Spinal cord disease paralysis; Spinal cord injury.

Publication types

  • Review

MeSH terms

  • Absorptiometry, Photon
  • Bone Density*
  • Humans
  • Osteoporosis / etiology
  • Osteoporosis / therapy
  • Spinal Cord Injuries* / complications