Osteoporosis and Heterotopic Ossification in Patients with Spinal Cord Injury - Education

Cardiac and pulmonary disorders are the leading causes of mortality and morbidity in spinal cord injury (SCI). As the life expectancy increased for patients with SCI, the prevalence of these disorders increased as well. The rate of yearly hospitalization due to cardiopulmonary problems is around 25-40% within 5-20 years after the injury. Sympathetic denervation associated with autonomic dysfunction leads to many cardiac and pulmonary problems. Furthermore, secondary conditions such as muscle denervation, immobility, obesity contribute to the morbidity related to cardiopulmonary problems. The prevalence of atherosclerotic heart diseases in patients with SCI is 30-50%, whereas it is 5-10% in healthy individuals; this implies a 5-6 fold increased risk in this population. Atherosclerotic heart disease appears at a younger age in cases of SCI and correlates with the level and completeness of the lesion. These data demonstrate the importance of awareness about cardiopulmonary problems and their complications. In this review, rehabilitation approches to these problems will be discussed and recent advances will be emphasized. Turk J Phys Med Rehab 2010; 56 Suppl 2: 67-74