Correlation Between Duration From Injury and Bone Mineral Density in Individuals With Spinal Cord Injury

Ann Rehabil Med, 2021 · DOI: https://doi.org/10.5535/arm.20169 · Published: February 9, 2021

Spinal Cord Injury Musculoskeletal Medicine

Simple Explanation

This study investigates the relationship between how long someone has had a spinal cord injury (SCI) and their bone mineral density (BMD). Bone loss is a known issue after SCI, but whether it affects the spine is debated. The researchers used a special type of X-ray (DXA) to measure BMD in the hip and spine of 83 individuals with SCI. They followed specific guidelines to ensure accurate spine measurements, excluding vertebrae with structural issues. The study found that longer duration of SCI correlated with lower BMD in the hip, but not in the spine. They also found that spine BMD measurement might not be a reliable way to assess fracture risk in individuals with SCI because of structural changes.

Study Duration

January 2009 and January 2019

Participants

83 individuals with SCI

Evidence Level

Not specified

Key Findings

1
A significant negative correlation was found between the duration from injury and femur neck BMD Z-score (r=-0.40, p<0.01).
2
A significant negative correlation was found between the duration from injury and total proximal femur BMD Z-score (r=-0.39, p<0.01).
3
No significant correlation was found between the duration from injury and spine BMD Z-score.

Research Summary

This study investigated the correlation between bone mineral density (BMD) and the duration of spinal cord injury (SCI) in individuals, while adhering to the 2007 International Society for Clinical Densitometry (ISCD) guidelines for BMD assessment. The study found a significant negative correlation between the duration from injury and hip BMD, specifically in the femur neck and total proximal femur, but not with spine BMD. The authors concluded that spine BMD measurement may not be an appropriate method for predicting future fracture risk in individuals with SCI due to structural changes in the spine.

Practical Implications

Hip BMD Monitoring

Regular monitoring of hip BMD is crucial for individuals with SCI, as the duration of injury is negatively correlated with hip BMD.

Re-evaluation of Fracture Risk Assessment

Traditional spine BMD measurements may not be reliable for predicting fracture risk in SCI patients; alternative methods focusing on hip BMD and other sites are needed.

Further Research

More research is needed to determine the most relevant site for BMD measurements in SCI patients, potentially focusing on the distal femur or proximal tibia.

Study Limitations

1
The study design was not prospective; thus, we could not conclude that BMD of the femur decreased with time and spine BMD did not.
2
We excluded only the vertebral levels with severe structural changes. Thus, we could not exclude the effects of the mild to moderate structural changes.
3
Many studies on SCI have used a nonparametric method because of the small number of subjects analyzed.

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