Osteoporosis after spinal cord injury

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Infographic by Crystal Han, inspired by SCIRE community page.

Edited by Rona Herzog

If you are interested in learning more, take a look at SCIRE Community’s page on Osteoporosis after SCI.


Osteoporosis commonly affects individuals with SCI, primarily occurring below the level of injury. This is termed sublesional (below the lesion) osteoporosis. As shown below, osteoblasts are cells that work to build bone, while osteoclasts are cells that break down bone. After SCI, osteoblasts are not able to build bone at the same rate as osteoclasts are breaking it down. High levels of bone breakdown, decreased bone mineral density (linked to strength of the bone) in the hip and/or knee area, and an increased likelihood of fracture can be associated with sublesional osteoporosis. 

Potential factors contributing to SCI and osteoporosis include:

  • overall changes to the body after injury, e.g. changes to the immune, hormonal, circulatory and nervous systems
  • decreased weight-bearing activities
  • decreased muscle activity
  • lifestyle changes after injury, e.g. amount of physical activity

The infographic below examines bone formation, bone regulation and osteoporosis after SCI.