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Neurological Rehabilitation

Use of Parathyroid Hormone Analogs for Treatment of Osteoporosis in Persons with Chronic Spinal Cord Injury

Friday, October 24, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 8

    Poster Presenter(s)

  • Samir Sherali, MD

    Academic Chief Resident Physician
    MetroHealth System/Case Western Reserve University PM&R Program
    Cleveland, Ohio

    • Co-Author(s)

  • Ryan L. Russell, DO (he/him/his)

    Resident Physician
    MetroHealth System/Case Western Reserve University PM&R Program
    Cleveland, Ohio

  • AA

    Anthony Anzivino, MD

    Resident Physician
    MetroHealth System/Case Western Reserve University PM&R Program
    Cleveland, Ohio

  • CO

    Christina Victoria Oleson, MD

    Director, Neuro-Osteoporosis Program, MetroHealth Rehabilitation Institute, Cleveland OH
    Case Western Reserve University
    Beachwood, Ohio

Disclosure(s):
Samir Sherali, MD: No financial relationships to disclose
Ryan L. Russell, DO: No financial relationships to disclose
Background and/or Objectives: Sublesional disuse osteoporosis develops rapidly in the first 16 months following acute complete spinal cord injury (SCI). Further progression ensues during chronic SCI. Immobilization, upregulation of osteoclastic activity, and subsequent reduction of osteoblastic activity 1-2 years post-injury results in net bone loss. Individuals with chronic SCI who have emerging or established osteoporosis would benefit from aggressive treatment that builds bone, rather than treatment that merely lessens the rate of bone loss. The parathyroid hormone analogs Teriparatide and Abaloparatide have known benefits in the general population and in mice with SCI. The objective of this study was to evaluate treatment response of Teriparatide and Abaloparatide on bone mineral density (BMD) in persons with chronic SCI.

Design: Longitudinal cohort study

Setting : Outpatient

Participants : 14 individuals with chronic complete SCI and sublesional osteoporosis diagnosed by dual-energy X-ray absorptiometry (DXA)

Interventions: Teriparatide, Abaloparatide

Main Outcome Measures: Change in BMD according to DXA measured before and after 2-year treatment with either Teriparatide or Abaloparatide.

Results: 8 individuals received Teriparatide and had an average improvement in BMD of +5.98% in Total Hip, +6.72% in Distal Femur, and +16.81% in Proximal Tibia. 6 individuals received Abaloparatide and had an average improvement in BMD of +1.19% in Total Hip, +13.28% in Distal Femur, and +23.58% in Proximal Tibia.

Conclusions: Teriparatide and Abaloparatide may have a role in the treatment of osteoporosis in individuals with chronic SCI. In this population which is at high risk for fractures and additional osteoporotic complications, there is substantial potential benefit from increasing bone mineralization rather than solely reducing bone loss. While this study is limited both in quantity and lack of comparison to a control group, the findings support the need for further investigation.