Bone Health Table 2: Fractures and risk factors for fragility fractures after SCI

First Author

Year

N

Age

Fractures

Risk Factors

Comarr

1962

1,363

19-58

81 patients with 109 lower extremity fractures (6% of the group)

complete spinal cord injury

Ragnarsson

1981

578

4-77

23 patients with 33 lower extremity fractures (4% of the group)

complete spinal cord injury

3,027

13-77

(National SCI Data Research Centre);44 patients with 52 lower extremity fractures (1.45% of the group)

N/A

Frisbie

1997

120

20-39

15 fractures/1000 patient years

increasing age

40-59

31 fractures/1000 patient years

60-79

46 fractures/1000 patient years

Vestergaard

1998

 

438

10-80

cumulative fracture incidence=21%

overall fracture rate 2%/yr

women > men; men with a family history of fractures;

 time since SCI longer than 3 yrs; level of SCI

McKinley

1999

N/A

population –based

all ages

women

1% (5 yrs)

2% (10 yrs)

3% (15 yrs)

6% (20 yrs)

women > men; time since SCI

men

1% (5 yrs)

1% (10 yrs)

2% (15 yrs)

2% (20 yrs

Lazo

2001

41

27-83

34% of participants had fractures

low BMD femoral neck

Nelson

2003

889

 

45 people fractured over 10 years (5% of the group)

women >men; time since injury

Garland

2004

152

19-71

N/A

completeness of injury; increasing age; low BMI

Zehnder

2004

98

18-59

0.4-30 yrs

2%/yr

time since injury; bone loss in lower extremity

<1 yr

1%/yr

1-9 yrs

1%/yr

10-19 yrs

3%/yr

20-29 yrs

5%/yr

Eser

2005

99

19-83

21% of the participants had lower extremity fractures

Time since injury; low BMD

Garland

2005

28

26-52

N/A

women >men; low BMD;

increasing age; low BMI; complete spinal cord injury; duration of injury

Carbone

2013a, 2013b

7447

 

892 participants had lower extremity fragility fractures over 5 years    (12% of the cohort)

Complete SCI; use of anticonvulsants (especially benzodiazepine class), heparin, opioid analgesia

*BMD=bone mineral density; BMI=body mass index; N/A=not available;pt yrs=patient years.

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