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Spinal Cord Injury-Induced Osteoporosis: Pathogenesis and Emerging Therapies |
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| Authors: | Ricardo A. Battaglino Antonio A. Lazzari Eric Garshick Leslie R. Morse |
| Affiliation: | 1. The Forsyth Institute, 245 First Street, Cambridge, MA, 02142, USA 2. Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA 3. Primary Care and Rheumatology Sections, VA Boston Healthcare System and Boston University School of Medicine, 150 S Huntington Ave, Boston, MA, 02130, USA 4. Pulmonary and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, 1400 Veterans of Foreign Wars Parkway, West Roxbury, MA, 02132, USA 5. Channing Laboratory, Department of Medicine, Brigham and Women??s Hospital, Harvard Medical School, Boston, MA, USA 6. Spaulding-Harvard SCI Model System, Spaulding Rehabilitation Hospital, 125 Nashua Street, Boston, MA, 02114, USA 7. Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA |
| Abstract: | Spinal cord injury causes rapid, severe osteoporosis with increased fracture risk. Mechanical unloading after paralysis results in increased osteocyte expression of sclerostin, suppressed bone formation, and indirect stimulation of bone resorption. At this time, there are no clinical guidelines to prevent bone loss after SCI, and fractures are common. More research is required to define the pathophysiology and epidemiology of SCI-induced osteoporosis. This review summarizes emerging therapeutics including anti-sclerostin antibodies, mechanical loading of the lower extremity with electrical stimulation, and mechanical stimulation via vibration therapy. |
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