Bone Loss and Fracture Risk Following Spinal Cord Injury: Patient Priorities and Treatment Options
| dc.contributor.advisor | Edwards, W. Brent | |
| dc.contributor.author | Crack, Laura Elizabeth | |
| dc.contributor.committeemember | Gabel, Leigh | |
| dc.contributor.committeemember | Kline, Greg | |
| dc.date.accessioned | 2024-04-30T16:31:33Z | |
| dc.date.available | 2024-04-30T16:31:33Z | |
| dc.date.issued | 2024-04-22 | |
| dc.description.abstract | Rapid and profound bone loss is a well-known secondary complication following spinal cord injury (SCI), occurring primarily below the level of neurological lesion due to mechanical disuse. The greatest loss of bone is experienced during the acute phase of injury, and established osteoporosis often persists into the chronic phase, with no current standard care plan for patients. The main goals of this thesis were to: (1) explore patient knowledge and awareness regarding bone loss, fracture risk and treatment options following SCI, and (2) to investigate pharmaceutical treatment options to prevent bone loss in acute SCI, as well as treat established osteoporosis in chronic SCI. Three independent studies were carried out and are presented in Chapters 3-5, respectively. Survey results demonstrated that while more than half of participants with SCI were able to correctly answer knowledge-based questions regarding bone health, less than one-fifth had received education on the topic, and approximately three-quarters were interested in learning more about treatment options. Our clinical trials demonstrated the efficacy of zoledronic acid (antiresorptive therapy) to mitigate loss of bone mineral and strength at the hip in acute SCI, regardless of one’s ability to regain ambulation following injury, and the efficacy of romosozumab (anabolic and antiresorptive monoclonal antibody therapy) to increase bone mineral and strength at the hip, but not the knee, in women with chronic SCI. These findings add to the existing body of literature suggesting zoledronic acid is a strong candidate for standard of care to mitigate bone loss during acute SCI, and indicating that further investigation is required to find a treatment that can increase bone mineral, and reduce fracture risk, at both the hip and knee during chronic SCI for those with established osteoporosis. | |
| dc.identifier.citation | Crack, L. E. (2024). Bone loss and fracture risk following spinal cord injury: patient priorities and treatment options (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. | |
| dc.identifier.uri | https://hdl.handle.net/1880/118484 | |
| dc.identifier.uri | https://doi.org/10.11575/PRISM/43326 | |
| dc.language.iso | en | |
| dc.publisher.faculty | Kinesiology | |
| dc.publisher.institution | University of Calgary | |
| dc.rights | University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission. | |
| dc.subject | Osteoporosis | |
| dc.subject | Bone Loss | |
| dc.subject | Spinal Cord Injury | |
| dc.subject.classification | Physiology | |
| dc.title | Bone Loss and Fracture Risk Following Spinal Cord Injury: Patient Priorities and Treatment Options | |
| dc.type | doctoral thesis | |
| thesis.degree.discipline | Kinesiology | |
| thesis.degree.grantor | University of Calgary | |
| thesis.degree.name | Doctor of Philosophy (PhD) | |
| ucalgary.thesis.accesssetbystudent | I require a thesis withhold – I need to delay the release of my thesis due to a patent application, and other reasons outlined in the link above. I have/will need to submit a thesis withhold application. |