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Longitudinal changes in bone in men with spinal cord injury
E D de Bruin1, V Dietz, M A Dambacher
1Laboratory for Biomechanics, Department of Materials, ETH Zurich, Switzerland. e.debruin@fh-aargau.ch
Clinical Rehabilitation
|April 14, 2000
Summary
Spinal cord injury significantly reduces bone strength in the tibia within two years. This study highlights the importance of assessing bone geometry and structure, not just density, for predicting fracture risk.
Area of Science:
- Orthopedics
- Biomedical Engineering
- Radiology
Background:
- Current bone assessment relies on bone mineral density (BMD), often overlooking crucial geometric and structural properties.
- Spinal cord injury (SCI) can lead to osteopenia, but its impact on bone structure is not routinely evaluated.
Purpose of the Study:
- To longitudinally assess changes in structural and geometric properties of tibia bone in individuals with SCI.
- To investigate the utility of peripheral quantitative computerized tomography (pQCT) and biomechanical testing for evaluating SCI-related bone changes.
Main Methods:
- 12 subjects with SCI underwent pQCT and bone stiffness measurements of the tibia.
- Measurements were taken around week 5 and week 104 post-SCI.
Main Results:
- Significant decreases in trabecular and cortical bone, as well as geometric properties, were observed within two years post-SCI (p < 0.05).
- Phase velocity propagation, a measure of bone integrity, changed in three subjects over the study period.
Conclusions:
- SCI induces alterations in bone geometry and structural properties in the lower extremities, beyond changes in tissue composition.
- Integrating geometric and biomechanical assessments with BMD could enhance screening for SCI-related osteopenia and improve fracture risk prediction.