Demineralization in tetraplegic and paraplegic man over time

Szollar, S M; Martin, Erin; Parthemore, Jacqueline G.; Sartoris, David J.; Deftos, Leonard J.

doi:10.1038/sj.sc.3100401

Cited by 59 publications

(33 citation statements)

References 4 publications

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“…This corresponds with previous ®ndings that hip BMD declines with increasing age and time after SCI. 12,14 This study also shows that BMD in the osteoporosis range by WHO standards may be associated with an increased risk of fractures in the SCI population. Though patients with osteoporosis only showed a trend towards a greater number of fracture events after SCI compared to the normal and osteopenic patients, the limited size of the study population may have a ected the outcome.…”

Section: Discussionsupporting

confidence: 55%

Osteoporosis and risk of fracture in men with spinal cord injury

et al. 2001

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Study design: Cross-sectional study to evaluate bone mineral density (BMD) and fracture history after spinal cord injury (SCI). Objectives: To determine frequency of osteoporosis and fractures after SCI, correlate extent of bone loss with frequency of fractures after SCI, and determine fracture risk in SCI patients. Setting: The Hines Veterans A airs Hospital in Hines, Illinois, USA. Methods: Femoral neck BMD was measured in 41 individuals with a history of traumatic or ischemic SCI using dual-energy X-ray absorptiometry (DEXA Lunar Whole Body Densitometer Model). Results: Twenty-®ve patients (61%) met the World Health Organization (WHO) criteria for osteoporosis, eight (19.5%) were osteopenic, and eight (19.5%) were normal. Fracture after SCI had occurred in 14 patients (34%). There were signi®cant di erences between the femoral neck BMD and SCI duration in patients with a fracture history compared to those without. For patients in the same age group, each 0.1 gm/cm 2 and each unit of standard deviation (SD) (t-value) decrement of BMD at the femoral neck increased the risk of fracture 2.2 and 2.8 times, respectively. Considered simultaneously with age, duration of SCI, and level of SCI, BMD was the only signi®cant predictor of the number of fractures. Conclusion: Osteoporosis and an increased frequency of fractures occur after SCI. Measurement of femoral neck BMD can be used to quantify fracture risk in SCI patients.

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Section: Discussionsupporting

confidence: 55%

Osteoporosis and risk of fracture in men with spinal cord injury

et al. 2001

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“…Tetraplegics demonstrate an initial post injury loss before attaining a BMD plateau, whereas paraplegics do not show any initial loss. 37,40 No signi®cant di erences have been found between tetraplegic and paraplegic SCI for BMD at the lumbar spine once this bone mass plateau has been reached. 37,40 The BMD of the lumbar spine was similar for both the tetraplegics and paraplegics in our study, and concurs with ®ndings by Szollar et al 37 but is contrary to those of Tsuzuku et al 14 The DOI of the two groups in the study by Tsuzuku et al 14 and ours may explain this di erence.…”

Section: Discussionmentioning

confidence: 99%

Intensive exercise may preserve bone mass of the upper limbs in spinal cord injured males but does not retard demineralisation of the lower body

2002

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Study design: Cross-sectional study comparing a group of active spinal cord injured (SCI) males carefully matched for age, height, and weight with active able-bodied male controls. Objectives: To compare bone mass of the total body, upper and lower limbs, hip, and spine regions in active SCI and able-bodied individuals. Setting: Outpatient study undertaken in two centres in New Zealand. Methods: Dual energy X-ray absorptiometry (DEXA) scanning was used to determine bone mass. Questionnaires were used to ascertain total time spent in weekly physical activity for each individual. The criterion for entry into the study was regular participation in physical activity of more than 60 min per week, over and above that required for rehabilitation. Results: Seventeen SCI and their able-bodied controls met our required activity criterion. Bone mineral density (BMD) values of the total body and hip regions were signi®cantly lower in the SCI group than in their controls (P=0.0001). Leg BMD and bone mineral content (BMC) were also signi®cantly lower in the SCI group (P=0.0001). By contrast, lumbar spine BMD and arm BMD and BMC did not di er between the SCI and control groups. Arm BMD and BMC were greater (not signi®cant) than the reference norms (LUNAR database) for both groups.

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“…Osteopenia leads in some individuals to osteoporosis with an increased risk of fractures. [1][2][3][4][5][6][7] Several authors report that approximately 2 years after the spinal cord injury, a new steady state between bone resorption and formation is reestablished. However, this steady state is reached after the patient has lost a significant amount of bone minerals.…”

Section: Introductionmentioning

confidence: 99%

Long-term changes in the tibia and radius bone mineral density following spinal cord injury

Bruin

Vanwanseele

et al. 2004

Spinal Cord

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Design: A prospective inception cohort study with an observational analytic design in a spinal cord injury (SCI) centre hospital. Objective: To assess changes in trabecular and compact bone of the tibia and radius prospectively in subjects with SCI. Subjects: In total, 10 individuals with an acute SCI. Methods: Trabecular and compact bone density of the tibia and radius by peripheral quantitative computerised tomography. Results: Analysis of the individual gradients of the curve coefficient showed changes in trabecular bone between À0.19 and À2.46 and in cortical bone between þ 0.07 and À0.93 in the tibia within 34 months after the SCI. Both trabecular and cortical bone showed a group mean loss of 99 mg/cm 3 . No changes were observed in the radius. Conclusion: There is a major decrease in tibia mineral density over 3 years; however, no change is observed for the radius mineral content. Large interindividual differences existed in the patterns of loss in the tibia bone substance after SCI. These patterns indicate that there is no steady state of bone mineral density following 3 years of spinal cord injury.

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Demineralization in tetraplegic and paraplegic man over time

Cited by 59 publications

References 4 publications

Osteoporosis and risk of fracture in men with spinal cord injury

Osteoporosis and risk of fracture in men with spinal cord injury

Intensive exercise may preserve bone mass of the upper limbs in spinal cord injured males but does not retard demineralisation of the lower body

Long-term changes in the tibia and radius bone mineral density following spinal cord injury

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