title: Dual-energy X-ray absorptiometry overestimates bone mineral density of the lumbar spine in persons with spinal cord injury.
abstract: BACKGROUND
  Bone mineral density (BMD) of the lumbar spine (L-spine) has been reported to be normal or increased in persons with chronic spinal cord injury (SCI).
  
  
  OBJECTIVE
  To determine BMD of the L-spine by dual-energy X-ray absorptiometry (DXA) and quantitative computerized tomography (qCT) in men with chronic SCI compared with able-bodied controls.
  
  
  METHODS
  Cross-sectional, comparative study.
  
  
  METHODS
  Clinical research unit, Veterans Affairs Medical Center, Bronx, NY, USA and Kessler Institute of Rehabilitation, West Orange, NJ, USA.
  
  
  METHODS
  Measurements of the L-spine were made in 20 men with SCI and compared with 15 able-bodied controls. The DXA images were acquired on a GE Lunar DPX-IQ. The qCT images of the L-spine were acquired on a Picker Q series computerized tomographic scanner.
  
  
  RESULTS
  The mean ages for the SCI and control groups were 44+/-13 vs 42+/-9 years, and the duration of injury of the group with SCI was 14+/-11 years. There were no significant differences between the SCI and control groups for L-spine DXA BMD (1.391+/-0.210 vs 1.315+/-0.178 g/m(2)) or for L-spine DXA T-score (1.471+/-1.794 vs 0.782+/-1.481). L-spine qCT BMD was significantly lower in the SCI compared with the control group (1.296+/-0.416 vs 1.572+/-0.382 g/m(2), P=0.05); the T-score approached significance (-1.838+/-1.366 vs -0.963+/-1.227, P=0.059). Subjects with moderate degenerative joint disease (DJD) had significantly higher T-scores by DXA than those without or with mild DJD.
  
  
  CONCLUSIONS
  Individuals with SCI who have moderate to severe DJD may have bone loss of the L-spine that may be underestimated by DXA, reducing awareness of the risk of fracture.
authors.affiliation: Veterans Affairs Rehabilitation Research and Development Center of Excellence for the Medical Consequences of Spinal Cord Injury, James J Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA. william.bauman@va.gov
authors.forename: W A
authors.initials: WA
authors.lastname: Bauman
authors.forename: E
authors.initials: E
authors.lastname: Schwartz
authors.forename: I S Y
authors.initials: IS
authors.lastname: Song
authors.forename: S
authors.initials: S
authors.lastname: Kirshblum
authors.forename: C
authors.initials: C
authors.lastname: Cirnigliaro
authors.forename: N
authors.initials: N
authors.lastname: Morrison
authors.forename: A M
authors.initials: AM
authors.lastname: Spungen
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density / Q000502:physiology*; D003430:Cross-Sectional Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D013119:Spinal Cord Injuries / Q000150:complications* / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed