Bone Mineral Density Testing in Spinal Cord Injury: 2019 ISCD Official Position

Leslie R. Morse, Fin Biering-Soerensen, Laura D. Carbone, Tomas Cervinka, Christopher M. Cirnigliaro, Therese E. Johnston, Nan Liu, Karen L. Troy, Frances M. Weaver, Christopher Shuhart, Beverley C. Craven

Research output: Contribution to journalArticlepeer-review

53 Scopus citations


Spinal cord injury (SCI) causes rapid osteoporosis that is most severe below the level of injury. More than half of those with motor complete SCI will experience an osteoporotic fracture at some point following their injury, with most fractures occurring at the distal femur and proximal tibia. These fractures have devastating consequences, including delayed union or nonunion, cellulitis, skin breakdown, lower extremity amputation, and premature death. Maintaining skeletal integrity and preventing fractures is imperative following SCI to fully benefit from future advances in paralysis cure research and robotic-exoskeletons, brain computer interfaces and other evolving technologies. Clinical care has been previously limited by the lack of consensus derived guidelines or standards regarding dual-energy X-ray absorptiometry-based diagnosis of osteoporosis, fracture risk prediction, or monitoring response to therapies. The International Society of Clinical Densitometry convened a task force to establish Official Positions for bone density assessment by dual-energy X-ray absorptiometry in individuals with SCI of traumatic or nontraumatic etiology. This task force conducted a series of systematic reviews to guide the development of evidence-based position statements that were reviewed by an expert panel at the 2019 Position Development Conference in Kuala Lumpur, Malaysia. The resulting the International Society of Clinical Densitometry Official Positions are intended to inform clinical care and guide the diagnosis of osteoporosis as well as fracture risk management of osteoporosis following SCI.

Original languageEnglish (US)
Pages (from-to)554-566
Number of pages13
JournalJournal of Clinical Densitometry
Issue number4
StatePublished - Oct 1 2019

Bibliographical note

Publisher Copyright:
© 2019 The International Society for Clinical Densitometry


  • Dual-energy X-ray absorptiometry
  • guidelines
  • official positions
  • spinal cord injury


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