BONE DENSITOMETRY IN PATIENTS WITH NEUROMUSCULAR DISORDERS

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Severe osteoporosis is a well known consequence of spinal cord injury, which causes hypercalcemia, hypercalciuria, kidney stones, soft tissue calcification and increased risk of pathologic fractures. The overall incidence of pathologic fractures is 1.4-6% and occurs most commonly from wheelchair falls. It has been demonstrated that prolonged periods of skeletal unloading such as strict bed rest, immobilization due to fractures and space flight leads to a negative calcium balance and osteoporosis. A Russian cosmonaut recently returned and was found to have a 19% decrease in his calcaneous bone density after only 140 days in microgravity. Spinal cord injury, neuromuscular disorders and microgravity have similar effects on bone metabolism. With the loss of weight bearing, there is a marked increase in bone resorption releasing bone calcium into the circulation. Within seven months after a spinal cord injury, or significant reduction in neuromuscular function, there is up to a 30% reduction in bone mass of affected skeletal areas. This increases the incidence of fractures, hypercalcemia, hypercalciuria, kidney stones and heterotopic ossification. We will enroll 100 adult patients with either spinal cord injury, or neuromuscular dysfunction due to other causes, such as, multiple sclerosis, cerebral palsy, muscular dystrophy, etc. Subjects who meet the following criteria will be considered for enrollment: a) >21 y/o with neuromuscular disease who are cared for at BMC; b) subjects who are immobilized or have marked decrease immobility due to either spinal cord injury or a neuromuscular disorder; c) negative urine pregnancy test; d) ability to provide verbal or written consent. We will look at changes in bone density over time.