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Bone Turnover and Spinal Cord Injury

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

Abstract

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.

Keywords

Spinal cord injury Bone turnover Osteoporosis Bone mineral density Biochemical marker 

List of Abbreviations

ALP

Alkaline phosphatase

B-ALP

Bone-specific alkaline phosphatase

BMC

Bone mineral content

BMD

Bone mineral density

BMI

Body mass index

CGRP

Calcitonin gene-related polypeptide

Cre

Creatinine

CTx

C-Telopeptide cross-link of type I collagen

DEXA

Dual energy X-ray absorptiometry

DPD

Deoxypyridinoline

HYPRO

Hydroxyproline

IL-6

Interleukin-6

LHRH

LH-releasing hormone

NDY

Neuropeptide Y

NTx

N-Telopeptide cross-link of type I collagen

OC

Osteocalcin

OPG

Osteoprotegerin

PICP

Procollagen type I C-terminal peptide

PINP

Procollagen type I N-terminal peptide

pQCT

Peripheral quantitative computed tomography

PTH

Parathyroid hormone

PYD

Pyridinoline

RANKL

NF-ĸB ligand

SCI

Spinal cord injury

TSH

Thyroid-stimulating hormone

VIP

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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