Alendronate increases bone density in chronic spinal cord injury: a case report

Area of Science:

• Orthopedics
• Neurology
• Endocrinology

Background:

• Spinal cord injury (SCI) can lead to significant bone mass loss and increased fracture risk within months.
• Alendronate, an aminobisphosphonate, is effective for increasing bone mass in postmenopausal women.
• The efficacy of alendronate in reversing bone density loss in chronic SCI patients remains largely unestablished.

Observation:

• This case study examines the effect of alendronate on bone mass in a patient with neurologically incomplete American Spinal Injury Association class D SCI and Brown-Séquard's syndrome.
• Bone mass changes were monitored over two years while the patient was taking oral alendronate.
• Comparisons were made between a weak extremity (muscle strength grade 2/5), a strong extremity (muscle strength grade 4/5), and the spine.

Findings:

• Alendronate treatment resulted in increased bone mineral density in the patient with chronic SCI.
• The increase in bone mineral density was greater in the weaker lower extremity compared to the stronger extremity.
• The spine exhibited the most significant overall increase in bone mineral density.

Implications:

• Alendronate may be a viable therapeutic option for mitigating bone density loss and reducing fracture risk in individuals with chronic SCI.
• Targeted treatment strategies may be beneficial, considering the differential response observed between weaker and stronger extremities.
• Further research is warranted to confirm these findings in larger cohorts of SCI patients.