Turkish Journal of Physical Medicine and Rehabilitation 2003 , Vol 49 , Num 2

Medulla Spinalis Yaralanmalı Hastalarda Parathormon, Kalsitonin ve Vitamin D Siklusu

Selda Bağış 1 ,Aynur Karagöz 2 ,Günşah Şahin 3 ,Canan Aybay 4
1 Acıbadem Üniversitesi, Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, Istanbul, Türkiye
2 Sağlık Bakanlığı, Ankara Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, Türkiye
3 Mersin Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Mersin, Türkiye
4 Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Arafltırma Hastanesi, 3. FTR Kliniği, Ankara, Türkiye

Bone resorption occurs rapidly after spinal cord injury and results in osteoporosis. The effect of parathormone, calcitonin and vitamin D status on osteoporosis is unclear. In this study 22 patients with spinal cord injury and 22 healthy control patients were evaluated. Serum total and ionized calcium, phosphorous, alkaline phosphatase, urinary calcium excretion, parathormone, calcitonin and vitamin D levels were measured. Age, sex, the duration of injury, the level of injury and functional ambulation level of patients were recorded. ASIA score was used for the motor evaluation and  FIM score was used for the evaluation of functional status. Total and ionized calcium, parathormone and 25 OH vitamin D concentrations were found significantly lower than control group and also phosphorous, calcitonin and urinary calcium excreation concentrations were higher than the control group (p<0.05). Parathormone concentration was found lower in the tetraplegic patients (p= 0.029) than the paraplegic patients and the patients with ASIA motor score <50 (p= 0.025). In conclusion  parathormone and vitamin D concentrations were suppressed in patients with spinal cord injury. We suggest that this suppression is correlated with the patient’s motor score and injury level.

Keywords : Spinal cord injury, parathormone, calcitonin, vitamin D