ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2016
Risk factors for osteoporotic fractures in persons with spinal cord injuries and disorders.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- An Evidence Map of the Women Veterans' Health Literature, 2016 to 2023: A Systematic Review.JAMA network open · 2025Pooled it
- Management of Mental Health Disorders, Substance Use Disorders, and Suicide in Adults with Spinal Cord Injury: Clinical Practice Guideline for Healthcare Providers.Topics in spinal cord injury rehabilitationGuideline
- Open-label clinical trial of alendronate after teriparatide therapy in people with spinal cord injury and low bone mineral density.Spinal cord · 2019Trial
- Disuse Bone Loss After Spinal Cord Injury: Scope and Challenges, Potential Mechanisms, Treatment, and Future Directions.Journal of the Endocrine Society · 2026Review
- Prevalence and associated factors of low bone mineral density in young adults with spinal cord injury.Irish journal of medical science · 2025Article
- A moderate spinal contusion injury in rats alters bone turnover both below and above the level of injury with sex-based differences apparent in long-term recovery.Bone reports · 2024Article
- Malunions following lower extremity fractures in veterans with a spinal cord injury/disorder.The journal of spinal cord medicine · 2024Article
- Leveraging genetics to optimize rehabilitation outcomes after spinal cord injury: contemporary challenges and future opportunities.Frontiers in genetics · 2024Article
- The positive role of physical therapy and appropriate technology in the reduction of bone mineral density loss associated with complete spinal cord injury: A case report.SAGE open medical case reports · 2024Article
- Prevalence and influencing factors of spinal cord injury-related osteoporosis and fragility fractures in Thai people with chronic spinal cord injury: A cross-sectional, observational study.The journal of spinal cord medicine · 2023Observational
- Comparison of Fractures Among Older Adults Who Are Ambulatory vs Those Who Use Wheelchairs in Sweden.JAMA network open · 2023Article
- Using Risk Scores to Estimate Lower Extremity Fragility Fracture Risk among Individuals with Chronic Spinal Cord Injury: A Preliminary Model.Topics in spinal cord injury rehabilitation · 2023Article
- Lower extremity fracture prevention and management in persons with spinal cord injuries and disorders: The patient perspective.The journal of spinal cord medicine · 2022Article
- Risk Factors and Consequences of Lower Extremity Fracture Nonunions in Veterans With Spinal Cord Injury.JBMR plus · 2022Article
- Factors influencing providers' decisions on management of bone health in people with spinal cord injury.Spinal cord · 2021Article
- Osteoporosis after spinal cord injury: aetiology, effects and therapeutic approaches.Journal of musculoskeletal & neuronal interactions · 2021Review
- Neurogenic Obesity and Skeletal Pathology in Spinal Cord Injury.Topics in spinal cord injury rehabilitation · 2021Review
- Management of Mental Health Disorders, Substance Use Disorders, and Suicide in Adults with Spinal Cord Injury.The journal of spinal cord medicine · 2021Article
- Long-Term Use of Oral Bisphosphonates and Fracture Risk in Men with Traumatic Spinal Cord Injury.Journal of physical medicine and rehabilitation (Wilmington, Del.) · 2020Article
- Predicting osteoporosis medication receipt in Veterans with a spinal cord injury: A retrospective cohort study.The journal of spinal cord medicine · 2019Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledClinical risk factors for fracture were explored among Veterans with a spinal cord injury. At the end of 11 years of follow-up, the absolute risk of fracture was approximately 20 %. Among the clinical and SCI-related factors explored, a prior history of fracture was strongly associated with incident fracture.
introductionFew studies to date have comprehensively addressed clinical risk factors for fracture in persons with spinal cord injury (SCI). The purpose of this study was to identify risk factors for incident osteoporotic fractures in persons with a SCI that can be easily determined at the point of care.
methodsThe Veteran's Affairs Spinal Cord Dysfunction Registry, a national database of persons with a SCI, was used to examine clinical and SCI-related risk factors for fracture. Incident fractures were identified in a cohort of persons with chronic SCI, defined as SCI present for at least 2 years. Cox regression models were used to estimate the risk of incident fractures.
resultsThere were 22,516 persons with chronic SCI included in the cohort with 3365 incident fractures. The mean observational follow-up time for the overall sample was 6.2 years (median 6.0, IQR 2.9-11.0). The mean observational follow-up time for the fracture group was 3.9 years (median 3.3, IQR 1.4-6.1) and 6.7 years (median 6.7, IQR 3.1-11.0) for the nonfracture group. By the end of the study, which included predominantly older Veterans with a SCI observed for a relatively short period of time, the absolute (i.e., cumulative hazard) for incident fractures was 0.17 (95%CI 0.14-0.21). In multivariable analysis, factors associated with an increased risk of fracture included White race, traumatic etiology of SCI, paraplegia, complete extent of SCI, longer duration of SCI, use of anticonvulsants and opioids, prevalent fractures, and higher Charlson Comorbidity Indices. Women aged 50 and older were also at higher risk of sustaining an incident fracture at any time during the 11-year follow-up period.
conclusionsThere are multiple clinical and SCI-related risk factors which can be used to predict fracture in persons with a SCI. Clinicians should be particularly concerned about incident fracture risk in persons with a SCI who have had a previous fracture.
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