Asian Spine Journal, 2020 · DOI: 10.31616/asj.2019.0004 · Published: February 1, 2020
Spinal cord injury (SCI) significantly impacts bone health, eventually leading to complications such as osteoporosis and pathological fractures. The rapid and extensive decline in bone density following SCI is greater than that seen upon immobilization alone. Bone turnover markers (BTMs) can potentially be used for fracture risk assessment as they respond earliest and reflect the underlying bone turnover process following spinal injury. A cost-effective and reliable assay of BTMs is now available with improved specificity and sensitivity. This is the first study in the Indian population evaluating BTMs in acute SCI and comparing them with those in healthy controls and a vulnerable population such as postmenopausal females.
Markedly elevated bone resorption markers in the SCI population, compared with those in control and vulnerable groups, emphasize the need for early bone health monitoring and management.
BTMs being dynamic metabolic responders can be used during the acute phase and follow-up investigations for fracture risk assessment and clinical decision-making for pharmacological management in patients with SCI.
Both BMD and BTMs together can complement each other and better prognosticate the fracture risk, which can aid in the clinical management of bone health in the SCI population.