Cyclical etidronate: its effect on bone density in patients with acute spinal cord injury.
OBJECTIVE
To compare the effects of a 30-week trial of cyclical etidronate therapy (starting within 6 weeks of spinal cord injury [SCI] and conventional rehabilitation without etidronate treatment on the bone density of the lumbar spine and lower extremities of SCI patients.


METHODS
Prospective, randomized control trial.


METHODS
Tertiary care, inpatient rehabilitation center.


METHODS
Acute SCI, within 6 weeks of injury. Thirteen SCI subjects were recruited; 6 were assigned randomly to receive etidronate and 7 to receive conventional treatment.


METHODS
Etidronate, 800 mg orally, once per day for 2 weeks of 15 weeks, repeated once.


METHODS
Dual X-ray absorptiometry of the spine, hip, distal femur, and proximal tibia measured at baseline, 6 months, and 12 months.


RESULTS
A significant interaction between etidronate treatment and ambulatory status over time was observed in the bone density of the patients after SCI (p = .0003). The patients who became ambulatory and received etidronate treatment had a preservation of bone density as compared to all other patients who showed a loss of bone density over time. The loss of bone density occurred in the leg bones, not the spine. Cyclical etidronate treatment was tolerated well without adverse or side effects.


CONCLUSIONS
Cyclical etidronate is a feasible treatment and may prevent osteoporosis associated with SCI in patients who eventually walk.
Pearson
E G
EG
Section of Physical Medicine and Rehabilitation, University of Manitoba, Winnipeg, Canada.
Nance
P W
PW
Leslie
W D
WD
Ludwig
S
S
D000208:Acute Disease; D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D001862:Bone Resorption / Q000503:physiopathology / Q000517:prevention & control*; D004334:Drug Administration Schedule; D012968:Etidronic Acid / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008124:Locomotion; D008297:Male; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000188:drug therapy / Q000503:physiopathology*
D012968:Etidronic Acid