Bone Turnover and Spinal Cord Injury

  • Roop SinghEmail author
Reference work entry
Part of the Biomarkers in Disease: Methods, Discoveries and Applications book series (BDMDA)


Spinal cord injury (SCI) causes rapid, severe osteoporosis with increased fracture risk. The pathogenesis of osteoporosis after SCI is a complex process and is usually attributed to “disuse” or “immobilization.” However, the exact pathophysiology of osteoporosis after SCI is still not clear. In SCI, bone remodeling becomes uncoupled with an initial decrease in bone formation and steadily increasing bone resorption. Osteoporosis after SCI can be evaluated by measuring BMD using DEXA, pQCT, and MRI; and estimating biochemical markers of bone turnover. Bone cell activity can be evaluated indirectly with techniques, such as specific serum and urine biochemical markers of bone turnover. An improved understanding of the natural history and risk factors for chronic bone loss following SCI is essential to designing therapies to reduce the rate of bone loss, define fracture risk, and ultimately prevent osteoporotic fractures and their associated morbidity. In conclusion, we are of the opinion that prospective randomized controlled trials should be conducted to evaluate, standardize, and find bone-specific biochemical marker of bone turnover, for the better understanding of the pathophysiology of osteoporosis in SCI.


Spinal cord injury Bone turnover Osteoporosis Bone mineral density Biochemical marker 

List of Abbreviations


Alkaline phosphatase


Bone-specific alkaline phosphatase


Bone mineral content


Bone mineral density


Body mass index


Calcitonin gene-related polypeptide




C-Telopeptide cross-link of type I collagen


Dual energy X-ray absorptiometry








LH-releasing hormone


Neuropeptide Y


N-Telopeptide cross-link of type I collagen






Procollagen type I C-terminal peptide


Procollagen type I N-terminal peptide


Peripheral quantitative computed tomography


Parathyroid hormone




NF-ĸB ligand


Spinal cord injury


Thyroid-stimulating hormone


Vasoactive intestinal polypeptide


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© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.Department of OrthopaedicsPandit B. D. Sharma PGIMSRohtakIndia

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