Osteoporosis in patients with paralysis after spinal cord injury : A cross sectional study in 46 male patients with dual-energy X-ray absorptiometry

• Published in: Archives of orthopaedic and trauma surgery 2001, Vol.121 (1-2), p.75-78
• Main Authors: SABO, Desiderius, BLAICH, Sören, WENZ, Wolfram, HOHMANN, Martin, LOEW, Markus, GERNER, Hans Jürgen
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon; Adult; Biological and medical sciences; Bone Density; Case-Control Studies; Cross-Sectional Studies; Femur - diagnostic imaging; Forearm - diagnostic imaging; Humans; Immobilization - adverse effects; Investigative techniques, diagnostic techniques (general aspects); Lumbar Vertebrae - diagnostic imaging; Male; Medical sciences; Osteoarticular system. Muscles; Osteoporosis - diagnostic imaging; Osteoporosis - etiology; Osteoporosis - prevention & control; Quadriplegia - complications; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radionuclide Imaging; Risk Factors; Spinal Cord Injuries - classification; Spinal Cord Injuries - complications
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s004020000162

In a cross-sectional study, 46 male patients with paralysis after spinal cord injury (average age 32 years; injuries sustained from 1 to 26 years ago; 33 Frankel A, 13 Frankel B, C, D) were examined clinically and by dual-energy X-ray absorptiometry (DEXA). Their bone mineral density (BMD) values were compared with age-related controls and correlated to clinical parameters. BMD was reduced in the proximal femur (p < 0.05) and the distal forearm (p < 0.05), but not in the lumbar spine. Demineralisation was influenced in the proximal femur (Z-score -2.95) by immobilisation after surgical treatment. Patients suffering from complete lesions had significantly lower BMD in the lumbar spine (-1.47) compared with patients with incomplete lesions (+0.02). BMD was not significantly influenced by the level of the lesion and the ambulatory status. Long-term monitoring showed significant demineralisation in the proximal femur (r = -0.36) and the distal forearm (r = -0.4), but not in the lumbar spine (r = -0.21). By correlating BMD with clinical parameters, it can be deduced that, firstly, immobilisation after surgical treatment should be reduced to a minimum; secondly, that every effort must be expended to prevent turning an incomplete into a complete lesion; and finally, that rehabilitation treatment should be lifelong.