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Surg Neurol Int 2021 19;12:170. Epub 2021 Apr 19.

School of Medicine, University of New Mexico, Albuquerque, New Mexico, United States.

Background: Odontoid process fractures are one of the most common spine fractures, especially in patients over age 70. There is still much controversy over the ideal candidate for anterior odontoid screw fixation (AOSF), with outcomes affected by characteristics such as fracture morphology, nonideal body habitus, and osteoporosis. Therefore, this systematic review seeks to discuss the optimal criteria, indications, and adverse postoperative considerations when deciding to pursue AOSF. Read More

PeerJ 2021 10;9:e11296. Epub 2021 May 10.

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Background: The impact of the type and the severity of disability on whole-body and regional body composition (BC), and bone mineral density (BMD) must be considered for dietary advice in athletes with a physical impairment (PI). This study aimed to investigate the impact of the type and the severity of disability on BC, the pattern of distribution of fat mass at the regional level, and BMD in athletes with a PI.

Methods: Forty-two male athletes with spinal cord injury (SCI, = 24; age = 40. Read More

J Clin Densitom 2021 Apr 6. Epub 2021 Apr 6.

Physical Medicine and Rehabilitation Department, General Hospital "G. Gennimatas", Athens, Greece.

During the acute and chronic phase of spinal cord injury (SCI) bone turnover and structure are affected. Bone mineral density of lower limbs is decreased up to 28%-50% below that of age-matched peers at 12-18 mo post injury. Coexisting secondary etiologies of osteoporosis may be present, and during ageing additional loss of bone occurs. Read More

Int J Mol Sci 2021 Apr 24;22(9). Epub 2021 Apr 24.

Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Bibai 072-0015, Japan.

Pyogenic spondylodiscitis can cause severe osteolytic and destructive lesions in the spine. Elderly or immunocompromised individuals are particularly susceptible to infectious diseases; specifically, infections in the spine can impair the ability of the spine to support the trunk, causing patients to be bedridden, which can also severely affect the physical condition of patients. Although treatments for osteoporosis have been well studied, treatments for bone loss secondary to infection remain to be elucidated because they have pathological manifestations that are similar to but distinct from those of osteoporosis. Read More

Exp Mol Med 2021 Apr 15;53(4):654-666. Epub 2021 Apr 15.

Department of Orthopedics, Tongji Hospital affiliated with Tongji University School of Medicine, Shanghai, China.

Senile osteoporosis can cause bone fragility and increased fracture risks and has been one of the most prevalent and severe diseases affecting the elderly population. Bone formation depends on the proper osteogenic differentiation of bone marrow stromal cells (BMSCs) in the bone marrow microenvironment, which is generated by the functional relationship among different cell types in the bone marrow. With aging, bone marrow provides signals that repress osteogenesis. Read More

Cureus 2021 Mar 9;13(3):e13791. Epub 2021 Mar 9.

Department of Orthopaedic Surgery, King George's Medical University, Lucknow, IND.

Introduction: Vitamin D deficiency has been implicated as an etiologic factor responsible for osteoporosis and various skeletal and extra-skeletal issues in spinal cord injury patients. There is a dearth of publications regarding the prevalence of vitamin D deficiency in acute spinal cord injury (ASCI) patients, thus it becomes imperative to study the status of vitamin D in ASCI cases to make an early diagnosis and start treatment for osteoporosis. Apart from this, we also planned to evaluate other factors associated with vitamin D deficiency in our subset of patients. Read More

J Spinal Cord Med 2021 Apr 8:1-11. Epub 2021 Apr 8.

Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research and Development Service, Department of Veterans Affairs, Hines VA Hospital, Hines, Illinois, USA.

Context/objective: To describe patient experiences with fracture prevention and management among persons with spinal cord injuries/disorders (SCI/D).

Design: Qualitative data collected via semi-structured telephone interviews.

Setting: Veterans Health Administration (VA) SCI/D System of Care. Read More

Int J Gen Med 2021 26;14:1121-1129. Epub 2021 Mar 26.

Department of Endocrinology, China Rehabilitation Research Center, Beijing, People's Republic of China.

Background: Spinal cord injury (SCI) can lead to disuse osteoporosis. The most vulnerable sites for fragility-induced fractures are the distal femur (DF) and proximal tibia (PT). The aim of this study was to evaluate changes in bone mineral density (BMD) at the DF and PT, as well as related factors, during the first year of SCI. Read More

Top Spinal Cord Inj Rehabil 2021 ;27(1):1-10

Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida.

Individuals with a spinal cord injury (SCI) have a unique physiology characterized by sarcopenia, neurogenic osteoporosis, neurogenic anabolic deficiency, sympathetic dysfunction, and blunted satiety associated with their SCI, all of which alter energy balance and subsequently body composition. The distinct properties of "neurogenic obesity" place this population at great risk for metabolic dysfunction, including systemic inflammation, hyperglycemia, dyslipidemia, and hypertension. The purpose of this article is to demonstrate the relationship between neurogenic obesity and the metabolic syndrome after SCI, highlighting the mechanisms associated with adipose tissue pathology and those respective comorbidities. Read More

Int J Mol Sci 2021 Mar 17;22(6). Epub 2021 Mar 17.

Department of Neurosurgery, Medical University of South Carolina, 96 Jonathan Lucas St., Charleston, SC 29425, USA.

Spinal cord injury (SCI) affects approximately 300,000 people in the United States. Most individuals who sustain severe SCI also develop subsequent osteoporosis. However, beyond immobilization-related lack of long bone loading, multiple mechanisms of SCI-related bone density loss are incompletely understood. Read More

Spinal Cord Ser Cases 2021 Mar 19;7(1):23. Epub 2021 Mar 19.

Inova Alexandria Hospital, Department of Medicine, Alexandria, VA, USA.

Introduction: Osteoporosis is a common secondary complication of spinal cord injury, with fragility fractures typically occurring in the lower body and management often is conservative.

Case Presentation: We present a 52-year-old male with chronic complete tetraplegia who presented to the emergency room with unremitting autonomic dysreflexia (AD). He was admitted for medical management of the AD when a source of the AD could not be identified. Read More

Calcif Tissue Int 2021 Mar 18. Epub 2021 Mar 18.

Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestrasse 59, 22529, Hamburg, Germany.

Disuse osteoporosis describes a state of bone loss due to local skeletal unloading or systemic immobilization. This review will discuss advances in the field that have shed light on clinical observations, mechanistic insights and options for the treatment of disuse osteoporosis. Clinical settings of disuse osteoporosis include spinal cord injury, other neurological and neuromuscular disorders, immobilization after fractures and bed rest (real or modeled). Read More

J Spinal Cord Med 2021 Mar 11:1-9. Epub 2021 Mar 11.

Health Services Research and Development Service, Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines, Illinois, USA.

Context/objective: The risk of lower extremity (LE) fractures in persons with spinal cord injury or disorders (SCI/D) is double that of the able-bodied population. LE fractures are the most common fracture location in SCI/D. Physical therapists (PTs) and occupational therapists (OTs) play an important role in rehabilitating LE fractures in Veterans with SCI/D. Read More

J Mater Chem B 2021 04;9(16):3489-3501

Department of Oral and Cranio-Maxillofacial Science, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China.

Osteoporosis (OP) is a major systemic bone disease leading to an imbalance in bone homeostasis which remains a challenge in the current treatment of bone defects. Our previous studies on strontium (Sr) doping apparently stimulated osteogenesis of bioceramics, which suggested a promising strategy for the treatment of bone defects. However, the potential effects and the underlying mechanisms of Sr-doping on osteoporotic bone defects still remain unclear. Read More

J Musculoskelet Neuronal Interact 2021 03;21(1):26-50

Department of Biomedical Engineering, Wolfson Building, University of Strathclyde, Glasgow, United Kingdom.

Osteoporosis is a long-term consequence of spinal cord injury (SCI) that leads to a high risk of fragility fractures. The fracture rate in people with SCI is twice that of the general population. At least 50% of these fractures are associated with clinical complications such as infections. Read More

Arch Biochem Biophys 2021 Feb 12:108805. Epub 2021 Feb 12.

Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.

Osteoporosis is a common complication accompanied by spinal cord injury (SCI) occurrence. MicroRNAs (miRNAs) have been proved to play a crucial role in the progression of osteoporosis, but their regulating mechanism is unclear. The present study investigated miRNA-19b-3p level in SCI rats induced by modified Allen method, as well as the role of miRNA-19b-3p in osteogenic differentiation of bone marrow-derived mesenchymal stem cells (BMSCs). Read More

Spinal Cord Ser Cases 2021 Feb 11;7(1):12. Epub 2021 Feb 11.

Physical Medicine and Rehabilitation Department, General Hospital G. Gennimatas, Athens, Greece.

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. Read More

Ann Rehabil Med 2021 Feb 9;45(1):1-6. Epub 2021 Feb 9.

Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.

Objective: To investigate the correlation between bone mineral density (BMD) and duration of injury in individuals with spinal cord injury (SCI).

Methods: Patients with SCI who visited the outpatient department between January 2009 and January 2019 were enrolled. Patients' most recent dual energy X-ray absorptiometry images were reviewed. Read More

Medicine (Baltimore) 2021 Jan;100(3):e24396

Department of Orthopaedic Surgery, College of Medicine, the Catholic University of Korea, Seoul, Korea.

Rationale: Traumatic atlantoaxial anteroinferior subluxation associated with a dens fracture and a Hangman fracture is a very rare and complex injury. Therefore, appropriate surgical strategy is not established.

Patient Concerns: An 85-year-old female presented with posterior neck pain and atypical neck position caused after rolling down a hill. Read More

Rev Med Interne 2021 Jan 15. Epub 2021 Jan 15.

Service d'addictologie et de psychiatrie de liaison, hôpital Saint-Jacques, CHU, 85, rue Saint-Jacques, 44093 Nantes, France; UMR 1246, universités de Nantes et Tours, France.

Abnormalities of hematological and biochemical parameters are various and frequent during anorexia nervosa, and are mainly related to malnutrition, weight loss, and compensatory purgative behaviors. They are most often moderate and reversible through appropriate nutritional and weight rehabilitation, as well as well-conducted symptomatic treatment. Severe abnormalities are rarer, but are potentially serious or even fatal. Read More

Calcif Tissue Int 2021 May 4;108(5):610-621. Epub 2021 Jan 4.

Centre for Orthopaedic and Trauma Research, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.

Neck of femur (NOF) fracture is a prevalent fracture type amongst the ageing and osteoporotic populations, commonly requiring total hip replacement (THR) surgery. Increased fracture risk has also been associated with Alzheimer's disease (AD) in the aged. Here, we sought to identify possible relationships between the pathologies of osteoporosis and dementia by analysing bone expression of neurotropic or dementia-related genes in patients undergoing THR surgery for NOF fracture. Read More

Osteoporos Int 2021 Jun 2;32(6):1117-1127. Epub 2021 Jan 2.

School of Rehabilitation Medicine, Capital Medical University, Beijing, China.

Bisphosphonates can inhibit osteoclast-mediated bone resorption, prevent bone loss, and reduce the risk of osteoporotic fractures. Our meta-analysis of studies shows that early bisphosphonate administration after SCI was safe and beneficial to the BMD of the total hip and lumbar spine at 12 months.

Introduction: Rapid bone loss in the early stages of spinal cord injury (SCI) leads to an increased risk of osteoporotic fracture. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Dec;34(12):1533-1538

Department of Orthopedics, the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen Guangdong, 518033, P.R.China.

Objective: To evaluate the effectiveness of cement-injectable cannulated pedicle screw combined with multiple level Schwab grade Ⅰ osteotomy for chronic thoracolumbar osteoporotic fractures with kyphosis.

Methods: The clinical data of 27 patients with symptomatic chronic thoracolumbar osteoporotic fractures combined with kyphosis treated between June 2015 and June 2017 were retrospectively analysed. Among them, there were 8 males and 19 females, with an average age of 69. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Dec;34(12):1526-1532

Department of Spinal Surgery, Honghui Hospital Affiliated to Medical School of Xi'an Jiaotong University, Xi'an Shaanxi, 710054, P.R.China.

Objective: To explore the safety and effectiveness of polymethylmethacrylate-augmented screw fixation (PASF) in the treatment of elderly thoracolumbar tuberculosis combined with severe osteoporosis.

Methods: The clinical data of 20 elderly patients with thoracolumbar tuberculosis and severe osteoporosis who underwent PASF after anterior or posterior debridement and bone grafting and met the selection criteria between December 2012 and December 2014 were retrospectively analyzed. There were 8 males and 12 females with an average age of 68. Read More

Brain Nerve 2020 Dec;72(12):1331-1343

Department of Neurology, Chubu Rosai Hospital.

Adult spinal deformity causing thoracolumbar hyperkyphosis is prevalent among the aging population, and is associated with impaired ADL and QOL. Corrective spine surgery is now developing for this common condition. Old patients with Parkinson's disease frequently have osteoporosis and vertebral compression fractures, which affect spinal deformity and postural abnormality. Read More

Cureus 2020 Oct 27;12(10):e11200. Epub 2020 Oct 27.

Medicine, University of Illinois at Urbana-Champaign, Champaign, USA.

Extracorporeal shock wave therapy (ESWT) is a non-invasive therapeutic method used for pain management and muscle strength improvement through the use of shock waves. In vitro studies have demonstrated that shockwave therapy induces fluctuation in redox reaction regulation and increases in Mitogen-Activated Protein Kinase (MAPK) signal transduction pathways, stimulating increased gene expression in the nucleus. ESWT has also been shown to upregulate angiogenesis and growth factors through activation of endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor (VEGF). Read More

Spinal Cord 2020 Nov 25. Epub 2020 Nov 25.

Department of Medicine, Division of Rheumatology, Medical College of Georgia at Augusta University, Augusta, GA, USA.

Study Design: Survey.

Objectives: Managing osteoporosis in persons with chronic spinal cord injury (SCI) is difficult as little evidence exists regarding effective strategies. We examined the effect of key factors on providers' bone health management decisions in persons with SCI. Read More

Aging (Albany NY) 2020 11 24;12(24):25673-25683. Epub 2020 Nov 24.

Hematology Center of Cyrus Tang Medical Institute, Soochow University School of Medicine, Suzhou 215123, China.

Atg7, a critical component of autophagy machinery, is essential for counteracting hematopoietic aging. However, the non-autophagic role of Atg7 on hematopoietic cells remains fundamentally unclear. In this study, we found that loss of Atg7, but not Atg5, another autophagy-essential gene, in the hematopoietic system reduces CD11b myeloid cellularity including CD11bLy6G and CD11bLy6G populations in mouse bone marrow. Read More

JBMR Plus 2020 Aug 25;4(8):e10375. Epub 2020 Jun 25.

Department of Veterans Affairs Rehabilitation Research & Development Service National Center for the Medical Consequences of Spinal Cord Injury James J. Peters Veterans Affairs Medical Center Bronx NY USA.

Persons with neurologically motor-complete spinal cord injury (SCI) have a marked loss of bone mineral density (BMD) of the long bones of the lower extremities, predisposing them to fragility fractures, especially at the knee. Denosumab, a commercially available human monoclonal IgG antibody to receptor activator of nuclear factor-κB ligand (RANKL), may provide an immunopharmacological solution to the rapid progressive deterioration of sublesional bone after SCI. Twenty-six SCI participants with subacute motor-complete SCI were randomized to receive either denosumab (60 mg) or placebo at baseline (BL), 6, and 12 months. Read More

World J Orthop 2020 Oct 18;11(10):453-464. Epub 2020 Oct 18.

Spinal Cord Injury and Disorders Center, Central Virginia VA Health Care System, Richmond, VA 23249, United States.

Background: Severe spasticity may negatively impact functionality and quality of life after spinal cord injury (SCI). Intrathecal baclofen treatment (IBT) is effectively used to manage severe spasticity and reduce comorbidities. However, long-term IBT may have a negative effect on bone mineral content (BMC), bone mineral density (BMD) and body composition (such as percentage fat mass and lean body mass). Read More