Prevention and management of osteoporosis and osteoporotic fractures in persons with a spinal cord injury or disorder: A systematic scoping review.
Prevention and management of osteoporosis and osteoporotic fractures in persons with a spinal cord injury or disorder: A systematic scoping review.
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脊髓损伤或疾病患者骨质疏松症和骨质疏松性骨折的预防和管理：系统范围审查。
DOI：
10.1080/10790268.2018.1469808
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Carbone,Laura
中科院分区：
文献类型：
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作者：
Zleik,Nour;Weaver,Frances;Harmon,RobertL;Le,Brian;Radhakrishnan,Reshmitha;Jirau-Rosaly,WandaD;Craven,BCatharine;Raiford,Mattie;Hill,JenniferN;Etingen,Bella;Guihan,Marylou;Heggeness,MichaelH;Ray,Cara;Carbone,Laura
目的：主要目的是回顾有关方法学的文献，以评估骨折风险，预防和治疗骨质疏松症，并管理骨质疏松性骨折的SCI/D。研究设计：Scoping review.Settings/Participants：人类成年受试者与SCI/D。结果措施：策略，以确定人与SCI/D的风险，骨质疏松症和apapricular fractions.Results的管理的非药物和药物治疗。结合DXA定义的低BMD以及临床和人口统计学特征，可预测SCI患者的骨质疏松性骨折风险。应考虑筛查继发性骨质疏松症，特别是甲状旁腺功能亢进、甲状腺功能亢进、维生素D不足和性腺功能减退。目前用于治疗骨质疏松症的抗吸收疗法具有有限的功效。使用手术治疗骨折的情况有所增加，在大多数情况下，结局良好，与保守治疗相当。骨折后的一个常见的不良事件是延迟health.Conclusions：在这一领域的研究大多数是有限的小样本量，弱的研究设计，并在研究人群中的显着变化。未来的研究需要解决队列定义和研究设计问题。
Objectives:The primary objective was to review the literature regarding methodologies to assess fracture risk, to prevent and treat osteoporosis and to manage osteoporotic fractures in SCI/D.Study Design:Scoping review.Settings/Participants:Human adult subjects with a SCI/D.Outcome measures:Strategies to identify persons with SCI/D at risk for osteoporotic fractures, nonpharmacological and pharmacological therapies for osteoporosis and management of appendicular fractures.Results:226 articles were included in the scoping review. Risk of osteoporotic fractures in SCI is predicted by a combination of DXA-defined low BMD plus clinical and demographic characteristics. Screening for secondary causes of osteoporosis, in particular hyperparathyroidism, hyperthyroidism, vitamin D insufficiency and hypogonadism, should be considered. Current antiresorptive therapies for treatment of osteoporosis have limited efficacy. Use of surgery to treat fractures has increased and outcomes are good and comparable to conservative treatment in most cases. A common adverse event following fracture was delayed healing.Conclusions:Most of the research in this area is limited by small sample sizes, weak study designs, and significant variation in populations studied. Future research needs to address cohort definition and study design issues.