Bone loss and fracture risk issues for veterans

By Thomas Crisp - Contributing Columnist

Breaking a bone is a common problem for patients with spinal cord injuries and research at the Charlie Norwood VA Medical Center is hoping to help clinicians identify those at most risk and help prevent it.

Research at the Augusta Veterans Affairs hospital and others across the country is an often overlooked aspect of the VA’s mission, an official said.

With a specialized and much-recognized Spinal Cord Injury unit and access to a database of spinal cord injury patients at VAs across the country, the VA researchers are well-positioned to study those patients.

The Augusta Spinal Cord Injury unit itself has about 1,500 patients with various degrees of injury that it follows, said Dr. Michael Priebe, the acting chief of spinal cord injury.

“It’s a sizable population,” he said. “That’s one of the advantages of doing research in a center like this is we can go through our registry and identify those people who would be the best targets for intervention and study.”

For instance, spinal cord injury patients tend to suffer from bone loss and many are at increased risk of fractures, Priebe said.

“It’s a huge problem because people with spinal cord injury, they can break their leg just while they are trying to put their shoe on,” he said. “These things are very important.”

Dr. Laura Carbone at the Augusta VA recently received a grant from the Department of Defense to look at who might be at increased risk for these fractures, and what might be the best way to screen patients for risk factors such as bone loss.

Carbone is studying whether bone density tests would be useful and whether the traditional site for such scans, which includes the hip, is relevant for patients who most often suffer lower leg injuries. She has already shown that a previous fracture puts these patients at higher risk for future fractures and has looked at the characteristics of those patients.

“Now what we’re trying to understand is, how can we directly translate this to patient care?” she said. “Are the drugs that we use for osteoporosis in the general population, do they work in a spinal cord injured population?”

Spinal cord injury patients lose bone rapidly after the injury and then continue to lose bone over time, Priebe said.

Part of that is losing the benefits of weight-bearing movement for many of these patients but there might also be other changes because of the loss of nerves and nerve activity, he said.

There is a difference in bone loss according to the degree of spinal injury, Carbone said.

“Patients who have a ‘complete’ spinal cord injury have a much higher degree of bone loss and a much greater risk of fracture,” she said. Research at the Augusta VA might not rival that at nearby Augusta University, but it is actually part of the VA’s mission and is made possible by the patients who come there,” said Dr. Thomas Hartney, associate chief of staff for research. “Patient care of the veterans is why they are here,” he said. “But they are an altruistic category of individuals who want to serve and so, when approached about a research protocol, are willing to give their time and extra efforts to be a participant in that.” (Source: The Augusta Chronicle | Tom Corwin | August 22, 2016)

By Thomas Crisp

Contributing Columnist

Thomas Crisp is a retired military officer from Whitmire. His veteran updates can be found weekly in The Newberry Observer.

Thomas Crisp is a retired military officer from Whitmire. His veteran updates can be found weekly in The Newberry Observer.

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