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Analysis of the evolution of cortical and trabecular bone compartments in the proximal femur after spinal cord injury by 3D-DXA

Osteoporosis International volume 29, pages 201–209 (2018)Cite this article

Abstract

Summary

Marked trabecular and cortical bone loss was observed at the proximal femur short-term after spinal cord injury (SCI). 3D-DXA provided measurement of vBMD evolution at both femoral compartments and cortical thinning, thereby suggesting that this technique could be useful for bone analysis in these patients.

Introduction

SCI is associated with a marked increase in bone loss and risk of osteoporosis development short-term after injury. 3D-DXA is a new imaging analysis technique providing 3D analysis of the cortical and trabecular bone from DXA scans. The aim of this study was to assess the evolution of trabecular macrostructure and cortical bone using 3D-DXA in patients with recent SCI followed over 12 months.

Methods

Sixteen males with recent SCI (< 3 months since injury) and without antiosteoporotic treatment were included. Clinical assessment, bone mineral density (BMD) measurements by DXA, and 3D-DXA evaluation at proximal femur (analyzing the integral, trabecular and cortical volumetric BMD [vBMD] and cortical thickness) were performed at baseline and at 6 and 12 months of follow-up.

Results

vBMD significantly decreased at integral, trabecular, and cortical compartments at 6 months (− 8.8, − 11.6, and − 2.4%), with a further decrease at 12 months, resulting in an overall decrease of − 16.6, − 21.9, and − 5.0%, respectively. Cortical thickness also decreased at 6 and 12 months (− 8.0 and − 11.4%), with the maximal decrease being observed during the first 6 months. The mean BMD losses by DXA at femoral neck and total femur were − 17.7 and − 21.1%, at 12 months, respectively.

Conclusions

Marked trabecular and cortical bone loss was observed at the proximal femur short-term after SCI. 3D-DXA measured vBMD evolution at both femoral compartments and cortical thinning, providing better knowledge of their differential contributory role to bone strength and probably of the effect of therapy in these patients.

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Fig. 1
Fig. 2

Abbreviations

SCI:

Spinal cord injury

BMD:

Bone mineral density

DXA:

Dual-energy X-ray absorptiometry

QCT:

Quantitative computed tomography

BMC:

Bone mineral content

vBMD:

Volumetric bone mineral density

3D-DXA:

Three-dimensional dual-energy X-ray absorptiometry

BMI:

Body mass index

AIS:

ASIA Impairment Scale

aBMD:

Areal bone mineral density

SD:

Standard deviation

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Funding

The study was funded by the Fundació la Marató de TV3. LH received support by the Programa Estatal de Promoción del Talento y su Empleabilidad—Torres Quevedo, Ministerio de Economía y Competitividad (Reference: SPTQ1300X006124XV0).

Author information

Author notes

  1. L. Gifre

    Present address: Rheumatology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain

Authors and Affiliations

  1. Rheumatology Department, Hospital Clinic of Barcelona, IDIBAPS, CIBERehd, Metabolic Bone Diseases Unit, Service of Rheumatology, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain

    L. Gifre, A. Monegal, N. Guañabens & P. Peris

  2. Galgo Medical, Barcelona, Spain

    L. Humbert

  3. Nuclear Medicine Department, Hospital Clínic of Barcelona, Barcelona, Spain

    A. Muxi

  4. CETIR, Barcelona, Spain

    L. Del Rio

  5. Guttmann Neurorehabilitation Institute, Universitat Autònoma de Barcelona, Badalona, Spain

    J. Vidal & E. Portell

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  1. L. Gifre
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  7. A. Monegal
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  8. N. Guañabens
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  9. P. Peris
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Corresponding author

Correspondence to P. Peris.

Ethics declarations

Ethical approval was obtained from the Neurorehabilitation Guttmann Institute and from the Hospital Clinic of Barcelona Ethics Committees, and all participants provided written informed consent.

Conflicts of interest

Ludovic Humbert is a stakeholder of Galgo Medical. LG, AM, LR, JV, EP, AMo, NG, and PP state that they have no conflicts of interest.

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Gifre, L., Humbert, L., Muxi, A. et al. Analysis of the evolution of cortical and trabecular bone compartments in the proximal femur after spinal cord injury by 3D-DXA. Osteoporos Int 29, 201–209 (2018). https://doi.org/10.1007/s00198-017-4268-9

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  • DOI: https://doi.org/10.1007/s00198-017-4268-9

Keywords

  • 3D-DXA
  • Bone mineral density
  • Cortical
  • DXA
  • Osteoporosis
  • Spinal cord injury
  • Trabecular