Calcified Tissue International

, Volume 80, Issue 5, pp 316–322

Treatment with Zoledronic Acid Ameliorates Negative Geometric Changes in the Proximal Femur following Acute Spinal Cord Injury

  • J. Shapiro
  • B. Smith
  • T. Beck
  • P. Ballard
  • M. Dapthary
  • K. BrintzenhofeSzoc
  • J. Caminis
Article

DOI: 10.1007/s00223-007-9012-6

Cite this article as:
Shapiro, J., Smith, B., Beck, T. et al. Calcif Tissue Int (2007) 80: 316. doi:10.1007/s00223-007-9012-6

Abstract

Acute spinal cord injury is associated with rapid bone loss and an increased risk of fracture. In this double-blind, randomized, placebo-controlled trial, 17 patients were followed for 1 year after administration of either 4 or 5 mg of zoledronic acid or placebo. Bone mineral density (BMD) and structural analyses of the proximal femur were performed using the hip structural analysis program at entry, 6 months, and 12 months. The 17 subjects completed 12 months of observation, nine receiving placebo and eight zoledronic acid. The placebo group showed a decrease in BMD, cross-sectional area, and section modulus and an increase in buckling ratio at each proximal femur site at 6 and 12 months. Six months after zoledronic acid, BMD, cross-sectional area, and section modulus increased at the femoral neck and intertrochanteric regions and buckling ratio decreased consistent with improved bone stability. However, at 12 months, the femoral narrow-neck values declined to baseline. In contrast to placebo, the intertrochanteric region and femur shaft were maintained at or near baseline through 12 months in the zoledronic acid-treated group. Urine N-telopeptide excretion was increased at baseline and declined in both the placebo and treatment groups during the 12 months of observation. We conclude that a single administration of zoledronic acid will ameliorate bone loss and maintain parameters of bone strength at the three proximal femur sites for 6 months and at the femur intertrochanteric and shaft sites for 12 months.

Keywords

Bone lossSpinal cord injuryZoledronic acidDual-energy X-ray absorptiometryHip structural analysis

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • J. Shapiro
    • 1
  • B. Smith
    • 2
  • T. Beck
    • 3
  • P. Ballard
    • 2
  • M. Dapthary
    • 3
  • K. BrintzenhofeSzoc
    • 4
  • J. Caminis
    • 5
  1. 1.Department of Physical Medicine and RehabilitationKennedy Krieger InstituteBaltimoreUSA
  2. 2.National Rehabilitation HospitalWashingtonUSA
  3. 3.Department of RadiologyJohns Hopkins University Outpatient CenterBaltimoreUSA
  4. 4.Catholic University of AmericaWashingtonUSA
  5. 5.Novartis Pharmaceuticals, Inc.East HanoverUSA