Osteoporosis and Osteopenia in Young Adults with Spinal Cord Injury: The Necessity of an Early Bone Mineral Density Checkup

Abstract Study design Retrospective cross-sectional study Objectives To identify the prevalence and risk factors for low bone mass (LBM) in young adults with spinal cord injury (SCI). Setting National Rehabilitation Center in Seoul, Korea Methods This study targeted patients with SCI aged 20–49 years hospitalized from January 2010 to October 2021. Bone mineral density was assessed using dual-energy X-ray absorptiometry of the lumbar spine, femoral neck, and total hip. Results Osteopenia was diagnosed in 451 patients (58.2%), and osteoporosis was diagnosed in 156 (20.1%) of 775 patients. Among 181 patients with time from injury within 3 months, 105 (58%) and 20 (11%) were diagnosed with osteopenia and osteoporosis, respectively. Additionally, the percentage of LBM increased significantly as the time from injury increased. On multivariate analysis, the risk factors for LBM in patients with acute SCI within 12 months of onset were age (odds ratio [OR]=1.04; 95% confidence interval (CI), 1.01 to 1.07; p =0.005), female sex (OR=2.49; 95% CI, 1.34 to 4.46; p =0.002), and body mass index (OR=0.86; 95% CI, 0.81 to 0.92; p <0.001). Furthermore, alcohol or smoking history, etiology of injury, neurological level of injury, completeness of injury, and the Korean version of the spinal cord independence measure-III score were not significantly correlated with LBM. Conclusions The prevalence of osteopenia and osteoporosis is high in young adults with SCI. In addition, the diagnosis rate is high in the test performed at the initial stages after injury. Therefore, early bone health monitoring should be performed in young adults with SCI.