Role of peripheral quantitative computed tomography in identifying disuse osteoporosis in paraplegia

Article English OPEN
Coupaud, S. ; McLean, A.N. ; Allan, D.B. (2009)
  • Publisher: Springer
  • Related identifiers: doi: 10.1007/s00256-009-0674-1
  • Subject: T1 | R1
    mesheuropmc: musculoskeletal system | musculoskeletal diseases

<b>Objective:</b> Disuse osteoporosis is a major long-term health consequence of spinal cord injury (SCI) that still needs to be addressed. Its management in SCI should begin with accurate diagnosis, followed by targeted treatments in the most vulnerable subgroups. We present data quantifying disuse osteoporosis in a cross-section of the Scottish paraplegic population to identify subgroups with lowest bone mineral density (BMD).\ud <b>Materials and Methods:</b> Forty-seven people with chronic SCI at levels T2-L2 were scanned using peripheral Quantitative Computed Tomography (pQCT) at four tibial sites and two femoral sites, at the Queen Elizabeth National Spinal Injuries Unit, Glasgow (U.K.). At the distal epiphyses, trabecular BMD (BMDtrab), total BMD, total bone cross-sectional area (CSA), and bone mineral content (BMC) were determined. In the diaphyses, cortical BMD, total bone CSA, cortical CSA, and BMC were calculated. Bone, muscle and fat CSAs were estimated in the lower leg and thigh.\ud <b>Results:</b> BMDtrab decreased exponentially with time since injury, at different rates in the tibia and femur. At most sites, female paraplegics had significantly lower BMC, total bone CSA and muscle CSA than male paraplegics. Subjects with lumbar SCI tended to have lower bone values and smaller muscle CSAs than in thoracic SCI. \ud <b>Conclusion:</b> At the distal epiphyses of the tibia and femur, there is generally a rapid and extensive reduction in BMDtrab after SCI. Female subjects, and those with lumbar SCI, tend to have lower bone values than males or those with thoracic SCI, respectively.\ud Keywords: Bone loss, osteoporosis, paraplegia, peripheral Quantitative Computed Tomography, spinal cord injury
  • References (19)
    19 references, page 1 of 2

    Chen B and Stein A. Osteoporosis in acute spinal cord injury. Top Spinal Cord Inj Rehabil 2003; 9(1): 26-35.

    Clin Endocrin 2006; 65: 555-565.

    Frey-Rindova P, de Bruin E, Stüssi E, Dambacher M and Dietz V. Bone mineral density in upper and lower extremities during 12 months after spinal cord injury measured by peripheral quantitative computed tomography. Spinal Cord 2000; 38: 26-32.

    Relationship between the duration of paralysis and bone structure: a pQCT study of spinal cord injured individuals. Bone 2004; 34(5): 869-880.

    Freehafer AA. Limb fractures in patients with spinal cord injury. Arch Phys Med Rehabil 1995; 76: 823-827.

    Vestergaard P, Krogh K, Rejnmark L and Mosekilde L. Fracture rates and risk factors for fractures in patients with spinal cord injury. Spinal Cord 1998; 36: 790-796.

    Eser P, Frotzler A, Zehnder Y and Denoth J. Fracture threshold in the femur and tibia of people with spinal cord injury as determined by peripheral Quantitative Computed Tomography. Arch Phys Med Rehabil 2005; 86: 498-504.

    Giangregorio L, McCartney N. Bone loss and muscle atrophy in spinal cord injury: epidemiology, fracture prediction, and rehabilitation strategies. J Spinal Cord Med 2006; 29: 489-500.

    Increased bone mineral density after prolonged electrically induced cycle training of paralyzed limbs in spinal cord injured man. Calcified Tissue Int 1997; 61: 22-25.

    [10] de Bruin ED, Frey-Rindova P, Herzog RE, Dietz V, Dambacher MA and Stüssi E (1999) Changes of tibia bone properties after spinal cord injury: effects of early intervention. Arch Phys Med Rehabil 1999; 80: 214-220.

  • Metrics
    No metrics available
Share - Bookmark