Abstract.The osteoporosis which appears in paraplegics below the neurological lesion has been studied in 100 patients with the following parameters: quantitative X-rays, urinary hydroxyproline excretion, kinetic study of calcium metabolism by 45Ca, serum phosphorus and calcium, parathormone and calcitonin radio-immunoassay, quantitative histology, density fractionation of bone and amino-acid composition of fractionated bone analysis.All our results show that the important bone resorption occurring very early in the paraplegia is immediately followed by an increase of the bone repair. This osteoporosis below the neurological lesion in paraplegia represents an unbalance between the synthesis and the resorption of bone which possesses a large degree of activity. Furthermore, we demonstrated that the collagen of this bone is underhydroxylated. Following the quanti tative X-rays and intraosseous phlebography results we have considered the aetiopatho genesis of this osteoporosis. It seems that vascular modifications due to the lesion of the autonomic nervous system play an important role and furthermore we believe that immobilisation represents only a minor factor in the aetiology of this osteoporosis.IN paraplegia an osteoporosis appears very early after the spinal cord lesion and is located below this lesion.The aetiopathogenesis of this osteoporosis is not known although the disuse factor has been advanced. On the other hand, the angiographic investigations made by Galibert (1959) and Rossier et al. (1973) have shown that modifications existed below the spinal lesion since the beginning of the paraplegia. Benassy et al. (1963) reported changes in the arterial and venous blood gases (02 saturation, pH, pC02, pOz) consisting in a marked arterialisation of lower limb venous blood. Thus, these modifications evolve in the same direction as the angiographic ones. These blood flow modifications could play a role in the pathogenesis of this porosis. Vasomotor paralysis, a consequence of the orthosympathic system damage, provokes a slowdown of the intraosseous circulation. Arterio-venous shunts also give an increase of the venous pressure. This situation leads to an increase of the intraosseous medullary pressure. Trueta (I964, 1968) and Dhem (1973) have shown the consequence of intraosseous circulation decrease on the cellular differentiation.Stimulated by these data and the fact that the autonomic nervous system CANS) might play a role in this osteoporosis, we have reviewed the problem and investigated the following parameters: X-rays; intramedullary pressure of bone; urinary hydroxyproline excretion; kinetic study of calcium metabolism by 45Ca; urine calcium; serum calcium and phosphorus; serum calcitonin and parathormone; quantitative histological study; density fractionation of bone and amino-acid composition of fractionated bone analysis.We will briefly summarise the methods and the results of those investigations which have been reported elsewhere.