Abstract
Study design
An online survey
Objectives
To describe current clinical practices regarding osteoporosis assessment and management in people with Spinal Cord Injury (SCI) and compare them to recommended diagnostic tests and interventions.
Setting
An international collaboration surveying professionals working in SCI Medicine.
Methods
Online cross-sectional survey regarding clinical practice trends in the assessment and treatment of osteoporosis in people with SCI. Assessment of whether discrete professional characteristics influenced practices and if those practices were consistent with recommendations from professional organizations.
Results
Eighty-two professionals working in SCI Medicine completed the survey. Respondents were equally likely to test for bone loss during the post-acute phase (between 4- and 18-months post injury) and after low impact fracture (41.46% and 42.68%, respectively) and more likely to test during the chronic phase (51.22%). The majority of respondents (n = 56, 70%) assessed bone density with DXA at the hip, and many (48.78%, n = 40) prescribed simultaneous mobilization, vitamin D and calcium to prevent bone loss in the acute, post-acute and chronic phases. A number of evaluations and interventions were inconsistent with best practice recommendations.
Conclusions
Given that reported practices for detection and treatment of osteoporosis in SCI are inconsistent and not data-driven, there is need for dissemination and adoption of existing clinical practice guidelines.
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References
Jiang SD, Dai LY, Jiang LS. Osteoporosis after spinal cord injury. Osteoporos Int. 2006;17:180–92.
Dionyssiotis Y. Spinal cord injury-related bone impairment and fractures: an update on epidemiology and physiopathological mechanisms. J Musculoskelet Neuronal Interact. 2011;11:257–65.
Morse LR, Biering-Soerensen F, Carbone LD, Cervinka T, Cirnigliaro CM, Johnston TE, et al. Bone Mineral Density Testing in Spinal Cord Injury: 2019 ISCD Official Position. J Clin Densitom. 2019;22:554–66.
Willnecker J. Measurement of bone density and bone strength with p QCT. In: Weinbauer GF, Vogel F (eds). Novel approaches towards primate toxicology. (Waxmann, 2006), pp. 13−19.
World Health Organisation. Assessment of fracture risk and its implication to screening for postmenopausal osteoporosis: technical report series 843. Geneva: WHO; 1994.
Sambrook P, Schrieber L, Taylor T, Ellis A. The musculoskeletal system. Edinburgh: Churchill Livingstone; 2001.
Frotzler A, Moosburger J, Kalke YB. Spinal Cord Injury related osteoporosis: The draft of the working group for Osteoprosis of the German-speaking Medical Society of Paraplegia (DMGP) as a basis for discussion. Osteol/Osteol. 2015;24:85–91.
Lewiecki EM, Compston JE, Miller PD, Adachi JD, Adams JE, Leslie WD, et al. FRAX(®) Bone Mineral Density Task Force of the 2010 Joint International Society for Clinical Densitometry & International Osteoporosis Foundation Position Development Conference. J Clin Densitom. 2011;14:223–5.
Morse L. Osteoporosis prophylaxis in acute SCI. Spinal Cord Ser Cases. 2019;5:27.
Dionyssiotis Y. Is prophylaxis for osteoporosis indicated after acute spinal cord injury? Spinal Cord Ser Cases. 2019;5:24.
Anderson D, Park AJ. Prophylactic treatment of osteoporosis after SCI: promising research, but not yet indicated. Spinal Cord Ser Cases. 2019;27:25.
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Dionyssiotis, Y., Marshall, R., Stillman, M.D. et al. A pulse survey: assessment and management of bone loss in spinal cord injury. Spinal Cord Ser Cases 7, 12 (2021). https://doi.org/10.1038/s41394-020-00361-7
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DOI: https://doi.org/10.1038/s41394-020-00361-7
