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Logo for the Journal of Rehab R&D
Volume 42 Number 3, May/June 2005
Pages 305 — 314


Abstract - Effect of pamidronate administration on bone in patients with acute spinal cord injury

William A. Bauman, MD;1-4* Jill M. Wecht, EdD;1 Steven Kirshblum, MD;5-6 Ann M. Spungen, EdD;1-2,4
Nancy Morrison, RN;1 Christopher Cirnigliaro, MS;1,5 Ernest Schwartz, MD1-2

1Department of Veterans Affairs (VA) Rehabilitation Research and Development Center of Excellence; 2Spinal Cord Damage Research Center (Mount Sinai School of Medicine); 3Medical, Spinal Cord Injury and Research Services, VA Medical Center, Bronx, NY; 4Department of Medicine and Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY; 5Kessler Institute of Rehabilitation, West Orange, NJ; 6New Jersey Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey (UMDNJ)-University Hospital and New Jersey Medical School, Newark, NJ
Abstract — Eleven subjects participated in a prospective placebo-controlled trial to address the efficacy of pamidronate in reducing bone loss in persons with acute spinal cord injury (SCI). We administered pamidronate (treatment) or normal saline (placebo) intravenously at baseline (22 to 65 days after injury) and sequentially over 12 months, with follow-up at 18 and 24 months. Regional bone mineral density (BMD) was lost over time, regardless of group. In the treatment group compared with the placebo group, we noted a mild early reduction in loss of total leg BMD. Significant bone loss from baseline occurred earlier in the placebo group at the regional sites than in the treatment group. However, by the end of the treatment and follow-up phases, both groups demonstrated a similar percent bone loss from baseline. Despite an early reduction in bone loss, pamidronate failed to prevent major, long-term bone loss in persons with acute neurologically complete SCI.
Key words: acute spinal cord injury, bisphosphonates, bone mineral content, bone mineral density, immobilization, N-telopeptide, osteocalcin, osteoporosis, pamidronate, paraplegia.

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