Calcified Tissue International

, Volume 38, Issue 6, pp 323–327 | Cite as

Bone remodeling during the development of osteoporosis in paraplegia

  • A. Chantraine
  • B. Nusgens
  • Ch. M. Lapiere
Clinical Investigations


Osteoporosis developing during the first weeks after the onset of traumatic paraplegia was studied with cortical and cancellous samples of iliac crest and tibia of 14 patients, and compared to normals. We used a procedure of bone particle fractionation (according to degree of mineralization) that allowed us to establish a profile reflecting the metabolic remodeling of bone and to analyze the organic matrix of the newly synthesized tissue. In paraplegics, we observed a large increase in the proportion of little calcified bone in the cortical as well as in the cancellous bone. Based on amino acid analyses, we found a decreased number of hydroxyproline residues in the newly synthesized organic matrix from paraplegia bone resulting either from an alteration of the prolyl hydroxylation or from the presence of an excess of noncollagen polypeptides. These results, together with previously published data reporting increased urinary hydroxylproline and calcium kinetic parameters, suggest an enhanced rate of skeletal remodeling in acute paraplegia. When investigated 2 years after injury, the patterns of distribution approach that of normal subjects.

Key Words

Osteoporosis Paraplegia Bone remodeling Bone matrix Bone mineralization 


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  1. 1.
    Chantraine A, Van Ouwenaller C, Hachen HJ, Schinas P (1979) Intra-medullary pressure and intra-osseous phlebography in paraplegia. Paraplegia 17:391–397PubMedGoogle Scholar
  2. 2.
    Klein L, Van de Noort S, Dejak JJ (1966) Sequential studies of urinary hydroxyproline and serum alkaline phosphatase in acute paraplegia. Med Serv J Can 22:524–533PubMedGoogle Scholar
  3. 3.
    Chantraine A (1971) Clinical investigation of bone metabolism in spinal cord lesions. Paraplegia 8:253–259PubMedGoogle Scholar
  4. 4.
    Minaire P, Meunier P, Edouard C, Bernard J, Courpron P, Bourret J (1974) Quantitative histological data on disuse osteoporosis. Calcif Tissue Res 17:57–73PubMedCrossRefGoogle Scholar
  5. 5.
    Chantraine A (1979) L'ostéoporose et les para-ostéo-arthropathies au cours de la paraplégie. Editions Arscia SA, Bruxelles, p 238Google Scholar
  6. 6.
    Lapiere ChM, Nusgens B (1970) Maturation-related changes of the protein matrix of bone. In: Balazs EA, (ed) Chemistry and molecular biology of the intercellular matrix, collagen, basal laminae elastin. Academic Press, London, New York, pp 55–98Google Scholar
  7. 7.
    Eastoe JE (1965) Methods for the determination of phosphate, calcium and protein in small portions of mineralized tissues. Proc 2nd European Symp on Calcified Tissues. Richelle LJ, Dallemagne MJ (eds) pp 265–374Google Scholar
  8. 8.
    Nusgens B, Chantraine A, Lapiere ChM (1972) Protein in the matrix of bone. Clin Orthop Rel Res 88:252–274CrossRefGoogle Scholar
  9. 9.
    Meunier P, Courpron P, Edouard C, Bernard J, Bringier, J., Vignon (1979) Physiological senile involution and pathological rarefraction of bone. Quantitative and comparative histological data. Clin Endocr 2:239–256CrossRefGoogle Scholar
  10. 10.
    Whyte MP, Bergfeld MA, Murphy WA, Avioli LV, Teitelbaum SL (1982) Postmenopausal osteoporosis: a heterogenous disorder as assessed by histomorphometric analysis of iliac crest bone from untreated patients. Am J Med 72:193–202PubMedCrossRefGoogle Scholar
  11. 11.
    Boyce BF, Scullion JE, Beastall G, Ferguson A, Cowan R, Fogelman I, Boyle IT (1982) Iliac bone histomorphometry in patients with femoral neck fracture in osteoporosis. Menczel J, Robin GC, Makin M, Steinberg R, (eds) Wiley Cichester, New York, pp 248–256Google Scholar
  12. 12.
    Chantraine A, Heynen G, Franchimont P (1979) Bone metabolism, parathyroid hormone, and calcitonin in paraplegia. Calcif Tissue Int 27:199–204PubMedCrossRefGoogle Scholar
  13. 13.
    Bergmann P, Heilporn A, Schoutens A, Paternot J, Tricot A (1977) Longitudinal study of calcium and bone metabolism in paraplegic patients. Paraplegia 15:147–159PubMedGoogle Scholar
  14. 14.
    Uhthoff HK, Jaworski ZFG (1978) Bone loss in response to long-term immobilisation. J Bone Joint Surg 60B:420–429Google Scholar
  15. 15.
    Donaldson CL, Hulley SB, Vogel JM, Hattner RS, Bayers JH, McMillan DE (1970) Effect of prolonged bedrest on bone mineral metabolism, 19:1071–1084Google Scholar
  16. 16.
    Hulley SB, Vogel JM, Donaldson CL, Bayers JH, Friedman RJ, Rosen SN (1971) The effect of supplemental oral phosphate on the bone mineral changes during prolonged bedrest. J Clin Invest 50:2506–2518PubMedCrossRefGoogle Scholar
  17. 17.
    Rosenbloom J, Harsch M, Jimenez S (1973) Hydroxyproline content determines the denaturation temperature of chick tendon collagen. Arch Biochem Biophys 156:478CrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc 1986

Authors and Affiliations

  • A. Chantraine
    • 1
  • B. Nusgens
    • 2
  • Ch. M. Lapiere
    • 2
  1. 1.Division de Médecine Physique et RééducationH.C.U.Genève 4Suisse
  2. 2.Laboratoire de Dermatologie expérimentaleInstitut de PathologieLiègeBelgique

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