Professional paper
Osteoporosis after spinal cord injury
Ivan DŽIDIĆ
; Spinal Unit Special Hospital for Medical Rehabilitation Varaždinske Toplice, Croatia
Saša MOSLAVAC
; Spinal Unit Special Hospital for Medical Rehabilitation Varaždinske Toplice, Croatia
Abstract
Spinal cord injury (SCI) and its impact on trabecular bone atrophy has been extensively studied in recent years. These patients are at increased risk for fractures, and evaluation of developed ostoporosis may be important in establishing adequate rehabilitation training. Clinical and biochemical investigations indicate that assesment of bone mineral density (BMD) by dual-energy x-ray absorptiometry is
useful index of neurogenic osteoporosis. We present 36 patients who have sustained traumatic spinal cord injury with paraplegia or tetraplegia, all at least one year post injury. Data were collected in Spinal Unit Special Hospital for Medical Rehabilitation in Varaždinske Toplice. Mean age at injury was 30,6±10,5 years (range 17–52
years) and median time post injury was 3 years (range 1–12 years) at the time of measurement. Overall BMD values (g/cm2) in proximal femur (hip) region was 0,727±0,171, with related T–score being –2,56±1,28, representing developed osteoporosis. Overall BMD values in proximal arm region was 0,649±0,038, T-score being –0,78±0,45. Considerable fall in BMD and T hip scores in both paraplegics
and tetraplegics was observed (T score being –2,68 and –2,44, respectively). There was a statistically significant difference between T-scores in hip and arm regions of paraplegic patients (-2,68±1,19 versus -0,57±0,31; P<0,05). As expected, there was no significant difference in hip and arm T score values in tetraplegic patients
(-2,44±1,44 versus -1,05±0,49; P<0,05). A large reduction of hip region BMD in both paraplegic and tetraplegic individuals was found, with mean femoral neck BMD being 67,2% and 70,4% of peak bone density, respectively. We failed to correlate activity level, time from injury and body mass index to the extent of BMD loss.
These findings confirm bone mineral loss in spinal cord injured patients, especially in paralyzed area.
Keywords
spinal cord injury; osteoporosis; bone mineral density
Hrčak ID:
129255
URI
Publication date:
28.7.2006.
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