Article

Sublesional declines in hip and knee region bone mass are a
well-established consequence of motor complete spinal cord injury (SCI), placing
individuals with SCI at risk for fragility fracture, hospitalization, and
fracture-related morbidity and mortality. OBJECTIVES: To describe the 1-year
incidence of fracture and osteoporosis prevalence in a community cohort of
Canadians with chronic SCI. METHODS: As part of the SCI Community Survey,
consenting adult participants with chronic SCI completed an online or telephone
survey regarding their self-reported medical comorbidities, including fracture
and osteoporosis, in the 12 months prior to survey conduct. Survey elements
included sociodemographic and impairment descriptors and 4 identified risk
factors for lower extremity fragility fracture: injury duration >/= 10 years,
motor complete and sensory complete (AIS A or A-B) paraplegia, and female gender.
RESULTS: Consenting participants included 1,137 adults, 70.9% were male, mean
(SD) age was 48.3 (13.3) years, and mean (SD) time post injury was 18.5 (13.1)
years. Eighty-four participants (7.4%) reported a fracture in the previous 12
months and 244 (21.5%) reported having osteoporosis in the same time period, with
corresponding treatment rates of 84.5% and 64.8%, respectively. The variables
most strongly associated with fracture were osteoporosis (odds ratio [OR], 4.3;
95% CI, 2.72-6.89) and having a sensory-complete injury (OR, 2.2; 95% CI,
1.38-3.50) or a motor complete injury (OR, 1.7; 95% CI, 1.10-2.72). CONCLUSIONS:
The discordance between fracture occurrence and treatment and the strength of the
association between osteoporosis diagnosis and incident fractures necessitates
improved bone health screening and treatment programs, particularly among persons
with complete SCI.

Langue : ANGLAIS