Can-SCIP Coach App
  1. Can-SCIP
  2. Recommendations
  3. Guidelines
  4. Section 2 - MANAGEMENT OF SCI COMPLICATIONS

L - BONE HEALTH




Individuals with incomplete SCI AIS D with lower extremity scores greater than or equal to 20 should be offered Etidronate to prevent sublesional osteoporosis, following a discussion of evidence-based benefits and risks. (CAN-SCIP 2020; Level A)
Individuals with motor complete SCI should be offered Alendronate (70 mg weekly), Zoledronate (5 mg IV) or Denosumab (60 mcg via subcutaneous injection) to maintain proximal and distal femur and proximal tibia BMD, following a discussion of evidence-based benefits and risks. (CAN-SCIP 2020; Level A)
Zoledronate should not be offered to individuals with renal impairment. (CAN-SCIP 2020; Level A)
Individuals with low bone mass should be offered vitamin D supplements to maintain lower extremity BMD. (CAN-SCIP 2020; Level A)
In individuals with SCI with low knee region BMD, FES cycling at least 3 times per week and 5 hours per week should be offered to maintain or improve knee region BMD in the areas stimulated, following a discussion of evidence-based benefits and risks. (CAN-SCIP 2020; Level C)