Effect of Alendronate on Bone in People With Chronic Spinal Cord Injury (SCI) Previously Treated With Teriparatide

This extension study will enroll individuals who have completed treatment in the parent
protocol "Effect of Teriparatide, Vibration and the Combination on Bone Mass and Bone
Architecture in Chronic Spinal Cord Injury" or in the teriparatide extension protocol. This
study will allow those individuals who previously received teriparatide to be treated for a
year with alendronate to maintain any bone they may have gained and to possibly increase bone
mass further. Termination of teriparatide is followed by bone loss if anti-resorptive therapy
is not initiated, so this approach is optimal for continued treatment of the current group of
participants.

Inclusion Criteria:

- Prior enrollment in protocol "Effect of Teriparatide, Vibration and the Combination on
Bone Mass and Bone Architecture in Chronic Spinal Cord Injury", (NCT01225055).

- Women of child-bearing potential and men must agree to use adequate contraception
(hormonal or barrier method of birth control; abstinence) prior to study entry, for
the duration of study participation, and for 90 days following completion of therapy.

- Ability to understand and the willingness to sign a written informed consent.

Exclusion Criteria:

- Individual with renal insufficiency (calculated creatinine clearance < 30 ml/min).

- Individuals who are not able to sit or stand upright for at least 30 minutes after
taking their medication.

- Individuals with poor dental hygiene.

- Individuals with esophageal abnormalities.

- Individuals who are not able to tolerate alendronate treatment.

- Individuals who will not be able to return for all study visits.

- Patients may not be receiving any other investigational agents.

- Other medical conditions that in the opinion of the investigator would preclude the
subject from completing the study