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Heterogeneity in microstructural deterioration following spinal cord injury
Ali Ghasem-Zadeh1, Mary P Galea2, Andrew Nunn2
1Depts of Medicine and Endocrinology, Austin Health, The University of Melbourne, Melbourne, Australia; Dept of Endocrinology, Austin Health, The University of Melbourne, Melbourne, Australia.
Bone
|November 30, 2020
Summary
Spinal cord injury causes significant bone loss, particularly in weight-bearing leg bones like the tibia. Bone microarchitecture deteriorates unevenly, with greater loss in the tibia compared to the radius.
Area of Science:
- Orthopedics
- Neuroscience
- Bone Biology
Background:
- Bone adapts to mechanical loading through modeling and remodeling.
- Unloading from spinal cord injury (SCI) can lead to bone resorption and compromised bone quality.
- Weight-bearing bones are hypothesized to experience more severe microstructural deterioration after SCI.
Purpose of the Study:
- To investigate regional differences in bone microstructural deterioration following spinal cord injury.
- To compare bone mineral density changes in the tibia, fibula, and radius in individuals with paraplegia and tetraplegia compared to controls.
Main Methods:
- Quantified volumetric bone mineral density (vBMD) using high-resolution peripheral quantitative computed tomography.
- Assessed 31 men with SCI (12 tetraplegia, 19 paraplegia) and 102 healthy controls.
- Expressed differences as standardized deviation (SD) scores relative to controls.
Main Results:
- Men with tetraplegia showed significant vBMD deficits in the distal tibia (-1.72 SD) and distal fibula (-0.68 SD) but not the distal radius.
- Men with paraplegia exhibited greater deficits in the distal tibia (-2.14 SD) and distal fibula (-0.83 SD).
- Distal tibial vBMD was significantly lower than distal fibular and distal radial vBMD in individuals with tetraplegia and paraplegia.
Conclusions:
- Bone microarchitectural deterioration after SCI is heterogeneous.
- Regional differences in bone loss may be related to region-specific strain thresholds influencing mechanotransduction.
