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Presumably because of immobilization and susceptibility to urinary tract infection, persons after spinal cord injury (SCI) are at increased risk for urinary stones. Analyzing data from the Model SCI Care Systems, a series of studies has been conducted to document the incidence and recurrence rate of kidney and bladder stones and to identify potential contributing factors, with an emphasis on environmental exposures. This article reviews these reports in comparison with general population data and discusses the plausibility of these findings in light of current knowledge about causal pathways to stone formation. The need for an effective prevention program is also addressed.