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Alteration of Volumetric Bone Mineral Density Parameters in Men with Spinal Cord Injury

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Abstract

Spinal cord injury (SCI) induces severe losses of trabecular and cortical volumetric bone mineral density (vBMD), which cannot be discriminated with conventional dual-energy X-ray absorptiometry (DXA) analysis. The objectives were to: (i) determine the effects of SCI on areal BMD (aBMD) and vBMD determined by advanced 3D-DXA-based methods at various femoral regions and (ii) model the profiles of 3D-DXA-derived parameters with the time since injury. Eighty adult males with SCI and 25 age-matched able-bodied (AB) controls were enrolled in this study. Trabecular and cortical vBMD, cortical thickness and derived strength parameters were assessed by 3D-SHAPER® software at various femoral subregions. Individuals with SCI had significantly lower integral vBMD, trabecular vBMD, cortical vBMD, cortical thickness and derived bone strength parameters (p < 0.001 for all) in total proximal femur compared with AB controls. These alterations were approximately to the same degree for all three femoral subregions, and the difference between the two groups tended to be greater for cortical vBMD than trabecular vBMD. There were minor differences according to the lesion level (paraplegics vs tetraplegics) for all 3D-DXA-derived parameters. For total proximal femur, the decreasing bone parameters tended to reach a new steady state after 5.1 years for integral vBMD, 7.4 years for trabecular vBMD and 9.2 years for cortical vBMD following SCI. At proximal femur, lower vBMD (integral, cortical and trabecular) and cortical thickness resulted in low estimated bone strength in individuals with SCI. It remains to be demonstrated whether these new parameters are more closely associated with fragility fracture than aBMD.

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Acknowledgements

The authors would like to express their thanks to the individuals with spinal cord injury and the controls for their participation.

Author information

Authors and Affiliations

  1. Département de Médecine Nucléaire, Hôpital Lapeyronie, CHU Montpellier, Montpellier, France

    Laurent Maïmoun & Denis Mariano-Goulart

  2. Département de Biophysique, Service de Médecine Nucléaire, PhyMedExp, INSERM, CNRS, Université de Montpellier, Hôpital Lapeyronie, 371, Avenue du Doyen Gaston Giraud, 34295, cedex 5, Montpellier, France

    Laurent Maïmoun, Pascal de Santa-Barbara & Denis Mariano-Goulart

  3. Centre Mutualiste PROPARA, Montpellier, France

    Anthony Gelis

  4. Department of Biostatistics, Clinical Epidemiology, Public Health, and Innovation in Methodology, Nimes University Hospital, University of Montpellier, Nîmes, France

    Chris Serrand & Thibault Mura

  5. 3D-Shaper Medical, Barcelona, Spain

    Ludovic Humbert

  6. Département de Médecine Nucléaire, Hôpital Carémeau, CHRU Nîmes, Nîmes, France

    Vincent Boudousq

  7. Institut d’Electronique Et Des Système, UMR CNRS 5214, Université de Montpellier, Montpellier, France

    Didier Laux

  8. CRF Bouffard-Vercelli USSAP, Perpignan, France

    Charles Fattal

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  1. Laurent Maïmoun
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Contributions

LM and DM-G contributed to conceptualisation. LM, CS and TM contributed to methodology. LM, LH, CS and TM contributed to software. LM, CS and TM contributed to validation. CS and TM contributed to formal analysis. LM, AG, VB, CF and DM-G contributed to investigation. LM, AG, PdS-B, CF contributed to resources . LM, CS and TM contributed to data curation. LM, DM-G contributed to writing—original draft. LM, AG, CS, TM, LH, VB, PdS-B, DL, CF and DM-G writing—review & editing. LM, CS and TM contributed to visualisation. LM, AG, CF and DM-G contributed to supervision. LM, AG, CF and DM-G contributed to project administration.

Corresponding author

Correspondence to Laurent Maïmoun.

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Conflict of interest

I certify that neither I (Laurent Maimoun) nor my co-authors (Anthony Gelis, Chris Serrand, Thibault Mura, Vincent Boudousq, Pascal de Santa-Barbara, Didier Laux, Charles Fattal, Denis Mariano-Goulart) have a conflict of interest that is relevant to the subject matter or materials included in this work. Ludovic Humbert is an employee and shareholder of 3D-Shaper Medical.

Human Rights and Informed Consent

Approval was obtained from Regional Research Ethics Committee (Comité de Protection des Personnes Sud-Mediterranee IV, Montpellier, France). All procedures used adhere to the tenets of the Declaration of Helsinki. Participants were given oral and written information and then delivered written informed consent.

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Maïmoun, L., Gelis, A., Serrand, C. et al. Alteration of Volumetric Bone Mineral Density Parameters in Men with Spinal Cord Injury. Calcif Tissue Int 113, 304–316 (2023). https://doi.org/10.1007/s00223-023-01110-2

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