Prevention and management of osteoporosis and osteoporotic fractures in persons with a spinal cord injury or disorder: A systematic scoping review.
J Spinal Cord Med
; 42(6): 735-759, 2019 11.
Article
en En
| MEDLINE
| ID: mdl-29745791
ABSTRACT
Objectives:
The primary objective was to review the literature regarding methodologies to assess fracture risk, to prevent and treat osteoporosis and to manage osteoporotic fractures in SCI/D.StudyDesign:
Scoping review.Settings/Participants:
Human adult subjects with a SCI/D.Outcomemeasures:
Strategies to identify persons with SCI/D at risk for osteoporotic fractures, nonpharmacological and pharmacological therapies for osteoporosis and management of appendicular fractures.Results:
226 articles were included in the scoping review. Risk of osteoporotic fractures in SCI is predicted by a combination of DXA-defined low BMD plus clinical and demographic characteristics. Screening for secondary causes of osteoporosis, in particular hyperparathyroidism, hyperthyroidism, vitamin D insufficiency and hypogonadism, should be considered. Current antiresorptive therapies for treatment of osteoporosis have limited efficacy. Use of surgery to treat fractures has increased and outcomes are good and comparable to conservative treatment in most cases. A common adverse event following fracture was delayed healing.Conclusions:
Most of the research in this area is limited by small sample sizes, weak study designs, and significant variation in populations studied. Future research needs to address cohort definition and study design issues.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Osteoporosis
/
Traumatismos de la Médula Espinal
/
Fracturas Osteoporóticas
Tipo de estudio:
Prognostic_studies
/
Systematic_reviews
Límite:
Adult
/
Humans
Idioma:
En
Revista:
J Spinal Cord Med
Asunto de la revista:
NEUROLOGIA
/
REABILITACAO
Año:
2019
Tipo del documento:
Article
País de afiliación:
Estados Unidos