Correlation Between Duration From Injury and Bone Mineral Density in Individuals With Spinal Cord Injury
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Objective To investigate the correlation between bone mineral density (BMD) and duration of injury in individuals with spinal cord injury (SCI). Methods Patients with SCI who visited the outpatient department between January 2009 and January 2019 were enrolled. Patients’ most recent dual energy X-ray absorptiometry images were reviewed. According to the 2007 International Society for Clinical Densitometry guidelines, vertebrae with a local structural change were excluded when deriving spine BMD. If one or no vertebra is suitable for evaluation, spine BMD was judged as “improper for assessment”. Correlation analysis was performed between duration from injury and BMD Z-scores of the hip and spine. Results Among 83 individuals with SCI, the spines of 44 were judged as improper for assessment. The correlation analysis showed a significant negative relationship between the duration from injury and femur neck BMD (r=-0.40, p<0.01) and total proximal femur BMD (r=-0.39, p<0.01). However, no significant correlation was found between the duration from injury and spine BMD Z-score. Conclusion The duration of SCI correlated with hip BMD, but not with spine BMD. Further, more than half of the individuals with SCI could not undergo spinal assessment due to local structural changes. Therefore, spine BMD measurement is not an appropriate method for predicting future fracture risk in those with SCI.
Abstract
Objective To investigate the correlation between bone mineral density (BMD) and duration of injury in individuals with spinal cord injury (SCI). Methods Patients with SCI who visited the outpatient department between January 2009 and January 2019 were enrolled. Patients’ most recent dual energy X-ray absorptiometry images were reviewed. According to the 2007 International Society for Clinical Densitometry guidelines, vertebrae with a local structural change were excluded when deriving spine BMD. If one or no vertebra is suitable for evaluation, spine BMD was judged as “improper for assessment”. Correlation analysis was performed between duration from injury and BMD Z-scores of the hip and spine. Results Among 83 individuals with SCI, the spines of 44 were judged as improper for assessment. The correlation analysis showed a significant negative relationship between the duration from injury and femur neck BMD (r=-0.40, p<0.01) and total proximal femur BMD (r=-0.39, p<0.01). However, no significant correlation was found between the duration from injury and spine BMD Z-score. Conclusion The duration of SCI correlated with hip BMD, but not with spine BMD. Further, more than half of the individuals with SCI could not undergo spinal assessment due to local structural changes. Therefore, spine BMD measurement is not an appropriate method for predicting future fracture risk in those with SCI.
참고문헌 (14)
- Cirnigliaro CM, "Progressive sublesional bone loss extends into the second decade after spinal cord injury", J Clin Densitom, 22, pp.185~194 (2019)
- Jiang SD, "Osteoporosis after spinal cord injury", Osteoporos Int, 17, pp.180~192 (2006)
- Jiang SD, "Mechanisms of osteoporosis in spinal cord injury", Clin Endocrinol(Oxf), 65, pp.555~565 (2006)
- Biering-Sorensen F, "Bone mineral content of the lumbar spine and lower extremities years after spinal cord lesion", Paraplegia, 26, pp.293~301 (1988)
- Jaovisidha S, "Influence of spondylopathy on bone densitometry using dual energy X-ray absorptiometry", Calcif Tissue Int, 60, pp.424~429 (1997)
- Resnick D, "Diagnosis of bone and joint disorders", pp.1372~1462 (1995), Saunders
- Lewiecki EM, "International Society for Clinical Densitometry 2007 Adult and Pediatric Official Positions", Bone, 43, pp.1115~1121 (2008)
- Zleik N, "Prevention and management of osteoporosis and osteoporotic fractures in persons with a spinal cord injury or disorder : a systematic scoping review", J Spinal Cord Med, 42, pp.735~759 (2019)
- Abderhalden L, "Dual-energy X-ray absorptiometry and fracture prediction in patients with spinal cord injuries and disorders", Osteoporos Int, 28, pp.925~934 (2017)
- Morse LR, "Bone mineral density testing in spinal cord injury : 2019 ISCD Official Position", J Clin Densitom, 22, pp.554~566 (2019)
- Edwards WB, "Bone imaging and fracture risk after spinal cord injury", Curr Osteoporos Rep, 13, pp.310~317 (2015)
- Cervinka T, "Agreement between fragility fracture risk assessment algorithms as applied to adults with chronic spinal cord injury", Spinal Cord, 55, pp.985~993 (2017)
- Eser P, "Fracture threshold in the femur and tibia of people with spinal cord injury as determined by peripheral quantitative computed tomography", Arch Phys Med Rehabil, 86, pp.498~504 (2005)
- Morse LR, "Dual energy x-ray absorptiometry of the distal femur may be more reliable than the proximal tibia in spinal cord injury", Arch Phys Med Rehabil, 90, pp.827~831 (2009)