The Natural History of Bone Loss in the Lower Extremity of Complete Spinal Cord-Injured Males

Bone loss at the lower extremity (LE) in complete spinal cord-injured (SCI) men is divided into three phases: acute, initial 4 months; subacute, subsequent 12 months; and chronic, yearly. Acute loss at the hip, knee, os calcis, and LE is .5%, 1%, 2%, and 2% per week, respectively; subacute loss is .5%, 1%, 1%, and 1% per month, respectively; chronic loss is the same at each site but annually. LE bone loss intensifies from proximal to distal sites. The loss is continuously downward in the LE, tibia, and os calcis but eventually slows at and above the knee with 50% of individuals eventually gaining bone mineral at the hip.