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Study Identifies Barriers to Bone Density Testing for Patients with Spinal Cord Injury


Spinal cord injury (SCI) is associated with severe osteoporosis that increases the risk of low-impact fractures (unrelated to trauma), and as many as 70% of individuals with SCI will sustain a bone fracture at some point following their spinal cord injury. Moreover, SCI-associated bone loss and fracture risk do not occur in the same locations as in those who suffer from other types of osteoporosis, thus are not generally included in standardized x-ray screening protocols. This study sought to identify barriers to routine bone mineral density (BMD) assessment for individuals with SCI. Investigators recruited 20 participants from a larger epidemiological study that assessed health in chronic SCI; participants included veterans treated within the VA healthcare system and non-veterans. The need for assistance to transfer the patient from a wheelchair to the x-ray scanning table was considered, as well as the patient’s level of injury, and scanning machine dimensions.

Findings revealed several barriers to routine BMD assessment among the SCI population, e.g., scanner design that limits accessibility, and increased scanning time that requires additional staff. To help lessen these barriers, investigators recommend several changes, such as: installing ceiling-mounted hydraulic lifts and grab bars to facilitate transfers in the screening room, increasing staff during scans, and partnering with administrators and staff to raise awareness of access issues faced by individuals with spinal cord injury.

PubMed Logo Morse L, Geller A, Stolzmann K, Matthess K, Lazzari A, and Garshick E. Barriers to providing dual energy x-ray absorptiometry services to individuals with spinal cord injury. American Journal of Physical Medicine and Rehabilitation 2009 Jan;88(1):57-60

This study was funded through VA/HSR&D’s Quality Enhancement Research Initiative (QUERI). Ms. Stolzmann, Mr. Matthess, and Drs. Lazzari and Garshick are part of the VA Boston Healthcare System.

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What are HSR&D Publication Briefs?

HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.