An early detection and intervention strategy to delay the onset of osteoporosis and reduce fracture incidence after spinal cord injury

The study aim is to evaluate a strategy for attenuating bone loss following spinal cord injury (SCI), through early detection of osteoporosis and intervention to slow its progression. People with chronic SCI suffer fragility fractures at high rates because disuse osteoporosis weakens bones, making them susceptible to fracture under minimal loading – e.g. from transfers between surfaces, or falling out of the wheelchair. By implementing appropriate bone health assessments, we can detect the initial signs of osteoporosis within weeks of injury, “red-flag” patients with fast-progressing osteoporosis and target them for intervention. Rates of bone loss compared between different time-points (pre-, during and post-intervention) provide the basis for assessment of the success of this osteoporosis management strategy. At the Queen Elizabeth National Spinal Injuries Unit, collaboration between researchers, spinal consultants and their clinical teams, combined with an embedded research environment, facilitate the recruitment of inpatients and monitoring of the impact of intervention.