Treatment with zoledronic acid ameliorates negative geometric changes in the proximal femur following acute spinal cord injury

Jay Shapiro, B. Smith, T. Beck, P. Ballard, M. Dapthary, K. BrintzenhofeSzoc, J. Caminis

Research output: Contribution to journalArticlepeer-review

61 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)316-322
Number of pages7
JournalCalcified Tissue International
Issue number5
StatePublished - May 2007


  • Bone loss
  • Dual-energy X-ray absorptiometry
  • Hip structural analysis
  • Spinal cord injury
  • Zoledronic acid

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Endocrinology


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