Osteoporosis in patients with paralysis after spinal cord injury. A cross sectional study in 46 male patients with dual-energy X-ray absorptiometry.
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.
Sabo
D
D
Stiftung Orthopädische Universitätsklinik Heidelberg, Abteilung Orthopädie I, Germany.
Blaich
S
S
Wenz
W
W
Hohmann
M
M
Loew
M
M
Gerner
H J
HJ
D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005269:Femur / Q000000981:diagnostic imaging; D005542:Forearm / Q000000981:diagnostic imaging; D006801:Humans; D007103:Immobilization / Q000009:adverse effects; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000517:prevention & control; D011782:Quadriplegia / Q000150:complications*; D011877:Radionuclide Imaging; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000145:classification / Q000150:complications*