Spinal Cord Injury as a Model of Bone-Muscle Interactions: Therapeutic Implications From in vitro and in vivo Studies

Marco Invernizzi, Alessandro de Sire, Filippo Renò, Carlo Cisari, Letterio Runza, Alessio Baricich, Stefano Carda, Nicola Fusco

Research output: Contribution to journalReview articlepeer-review


Spinal cord injuries (SCIs) represent a variety of conditions related to the damage of the spinal cord with consequent musculoskeletal repercussions. The bone and muscle tissues share several catabolic pathways that lead to variable degrees of disability in SCI patients. In this review article, we provide a comprehensive characterization of the available treatment options targeting the skeleton and the bone in the setting of SCI. Among the pharmacological intervention, bisphosphonates, anti-sclerostin monoclonal antibodies, hydrogen sulfide, parathyroid hormone, and RANKL pathway inhibitors represent valuable options for treating bone alterations. Loss phenomena at the level of the muscle can be counteracted with testosterone, anabolic-androgenic steroids, and selective androgen receptor modulators. Exercise and physical therapy are valuable strategies to increase bone and muscle mass. Nutritional interventions could enhance SCI treatment, particularly in the setting of synergistic and multidisciplinary interventions, but there are no specific guidelines available to date. The development of multidisciplinary recommendations is required for a proper clinical management of SCI patients.

Original languageEnglish
Article number204
JournalFrontiers in Endocrinology
Publication statusPublished - Apr 15 2020


  • bone
  • bone loss
  • muscle
  • osteoporosis
  • rehabilitation
  • sarcopenia
  • spinal cord injury

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism


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