Osteoporosis is a systemic skeletal disease characterized by low bone mass and decreased skeletal content. In patients with a spinal cord injury, this disorder leads to higher bone fragility.
All patients with a complete spinal cord injury are affected by this disease due to their risk of pathological fractures that are increased. There are many factors that can influence bone mass such as the severity of the injury, muscle spasticity, pharmacological intervention, gender, etc.
Immediately after the spinal cord injury has been struck, bone mass starts decreasing at the following rate: 2% monthly during the first six months and 1% during the rest of the year. This is due to the patient’s immobilization especially right after the injury has occurred.
The pelvis and lower limbs are the most affected areas by osteoporosis in patients with a spinal cord injury. This disorder usually appears due to the lack of movement.
Consequences of pathological fractures
If a patient with a spinal cord injury suffers from fractures due to osteoporosis, it is likely for him/her to suffer other fracture-related diseases:
- Exuberant calluses which increase spasticity.
- Pressure ulcers
- Deep vein thrombosis, etc.
Since the patient loses bone mass and is weaker, it is possible for him/her to require immobilization for some time and being under medical supervision in order to avoid pressure ulcers and to treat pain and spasticity. If there aren’t risk factors, the patient may undergo the appropriate surgical intervention to treat his fractures.
However, osteoporosis in patients with a spinal cord injury causes a lack of self-reliance and therefore a much reduced quality of life for the patient.
Some improvements have been currently accomplished according the diagnose, prevention and treatment of osteoporosis in patients with a spinal cord injury if we consider that it was a unreasearched field to have such a great importance.
It has been proved that both physical exercise and physiotherapeutic treatments improve health conditions of patients with spinal cord injury related osteoporosis.
Sport increases bone density from 1 to 3% and provides better muscle mobility, agility and strength. Physical rehab plays an important role in improving the quality of life of patients with a spinal cord injury since it reduces muscle atrophy, increases spasticity, balance and overall physical conditions and therefore, increases self-reliance.
Furthermore, physiotherapeutic treatments help to prevent and improve this disease. It has been proved that functional electrostimulation (FES) is one of the best tools to avoid osteoporosis in a patient with a spinal cord injury.
The Kabat method for spinal cord injury is also a recommended treatment for these cases.