Spinal cord injury hypercalcemia: therapeutic profile.

During the course of hospitalization for comprehensive rehabilitation, a 14-year-old boy with C4 spinal cord injury and hypercalcemia was treated with 5 different treatment regimens which were instituted to reduce the hypercalcemia and associated complications. These regimens included low calcium diet, steroids, oral phosphates, intravenous saline, diuretics, hyperalimentation, calcitonin and spironolactone in various combinations, and mobilization. Careful metabolic monitoring carried out throughout hospitalization permitted the evaluation in retrospect of the impact of each treatment regimen, and, to a lesser extent, the impact of their individual components. Among all the therapeutic modalities, the most effective variables in reducing hypercalcemia in this patient were mobilization in the form of wheelchair sitting for long-term effects, and saline, furosemide, and calcitonin for short-term effects.