Objective To explore the regulatory role of immunoinflammatory mechanism regulated by tiny RNAs （miRNAs） in the pathogenesis of spinal cord injury-induced osteoporosis （CSCI-OP）. Methods Thirty patients with CSCI-OP admitted to our hospital from July 2021 to July 2022 were selected as the observation group， fifty patients with senile osteoporosis were selected as the control group， and fifty healthy people were selected as the normal control group. The three groups were compared in terms of hormone indexes， inflammatory factors， miRNAs expression and bioinformatics analysis. The main factors affecting the pathogenesis of CSCI-OP patients were detected. Results Compared with the spinal cord injury group， the T and TNF-α levels were increased， and the E2， IL-6 and BLAP levels were decreased in the senile osteoporosis group （P < 0.05）， but there was no significant difference in 25-OHD and PTH levels between the two groups （P > 0.05）. Univariate analysis showed that the incidence of CSCI-OP was mainly related to age， sex， duration of spinal cord injury and diabetes mellitus （P < 0.05）. Compared with the normal control group， the expression of IL-6 miRNA and BLAP miRNA in the control group and observation group was increased and the expression of TNF-α miRNA was decreased （P < 0.05）. Conclusion MiRNAs can be effectively regulated in CSCI-OP. It can significantly slow down the occurrence and development of CSCI-OP through targeted immune inflammatory mechanisms.