Bone Mineral Density in Spinal Cord Injury: An Evaluation of the Distal Femur

Journal of Osteoporosis, 2012 · DOI: 10.1155/2012/519754 · Published: July 9, 2012

Spinal Cord Injury Musculoskeletal Medicine

Simple Explanation

Osteoporosis in spinal cord injury (SCI) patients is a secondary condition influenced by many factors. Diagnosing osteoporosis and determining fracture risk using bone mineral density (BMD) measurements from DXA scans remains challenging in this group. This study aimed to assess bone mineral loss using DXA scans, examining its connection to body composition and the occurrence of fractures in individuals with complete paraplegia, compared to a control group of similar age. The study also includes the distal femur. The research suggests that the distal femur might be a more effective location for DXA scans to identify bone loss in SCI patients than the more commonly assessed proximal femur.

Study Duration

Not specified

Participants

25 SCI patients and 17 controls

Evidence Level

Clinical Study

Key Findings

1
BMD was significantly lower in SCI patients than in controls at all femoral sites (femoral neck, total femur, and distal femur).
2
There was no significant difference in lumbar spine BMD between SCI patients and controls.
3
An inverse relationship was found between the time since SCI and bone mineral mass specifically at the distal femur BMD.

Research Summary

This study evaluated bone mineral density (BMD) in spinal cord injury (SCI) patients compared to controls, focusing on the distal femur as a potentially more sensitive site for assessing bone loss. The findings indicated that BMD was significantly lower at all femoral sites in SCI patients, but only the distal femur showed a correlation with the duration of the injury. The research suggests prioritizing the analysis of inferior limbs, including the distal femur, in SCI patients and excluding lumbar spine analysis due to its limitations and lack of significant bone loss detection.

Practical Implications

Improved Diagnostic Accuracy

The distal femur may be a more sensitive site for assessing bone loss in SCI patients, potentially leading to earlier detection and intervention.

Targeted Treatment Strategies

Focusing on the distal femur could inform the development of targeted treatments to prevent fractures in SCI patients.

Refined Clinical Protocols

Clinical protocols for bone mass assessment in SCI patients could be updated to include the distal femur and potentially exclude lumbar spine analysis.

Study Limitations

1
Cross-sectional study design limits the ability to establish causality between time since SCI and bone loss.
2
Relatively short period of spine cord injury, limiting correlation between bone mass and fractures.
3
The study population was limited to male patients, potentially limiting the generalizability of the findings to women.

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