Beyond the initial impact: a systematic review of post-traumatic bone loss and its mechanisms
Authors' conclusion
Post-traumatic bone loss presents a distinct etiology, resulting from an interaction of mechanical, inflammatory, neural, nutritional, and hormonal factors.
Study context
- Population
- Clinical and preclinical studies of bone loss after major injuries (traumatic brain injury (TBI), spinal cord injury (SCI), burns, fractures)
- Participants
- 165 studies
- Comparison
- TBI vs SCI vs Burns vs Fractures
- Outcome
- Post-traumatic bone loss by injury type
Methodological detailsPRISMA guidelines, PubMed, Web of Science, Scopus and Science Direct searched up to January 2025
- PRISMA guidelines
- PubMed, Web of Science, Scopus and Science Direct searched up to January 2025
Pooled result
As reported in the abstract
SCI: BMD reduction within weeks, up to
50%
Burns: BMD loss within two months, up to
8%
Burns: osteoporosis affecting patients
10 to 50%
Fractures: BMD changes in the injured limb
5 to 28%
Further pooled results
Potential mechanisms
- Mechanical unloading with increased sclerostin signaling
- Systemic inflammation driving osteoclastogenesis
- Nervous system dysregulation changing neuroosteogenic interaction
- Nutritional and metabolic imbalances
- Hormonal disturbances involving parathyroid hormone, growth hormone and cortisol
Original publication
Beyond the initial impact: a systematic review of post-traumatic bone loss and its mechanisms. Osteoporos Int. Published 28 October 2025. doi:10.
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