UNLABELLED: In this cross-sectional study, we found that areal bone mineral density (aBMD) at the knee and specific tibia bone geometry variables are associated with fragility fractures in men and women with chronic spinal cord injury (SCI). INTRODUCTION: Low aBMD of the hip and knee regions have been associated with fractures among individuals with chronic motor complete SCI; however, it is unclear whether these variables can be used to identify those at risk of fracture. In this cross-sectional study, we examined whether BMD and geometry measures are associated with lower extremity fragility fractures in individuals with chronic SCI. METHODS: Adults with chronic [duration of injury ≥ 2 years] traumatic SCI (C1-L1 American Spinal Cord Injury Association Impairment Scale A-D) reported post injury lower extremity fragility fractures. Dual-energy X-ray absorptiometry (DXA) was used to measure aBMD of the hip, distal femur, and proximal tibia regions, while bone geometry at the tibia was assessed using peripheral quantitative computed tomography (pQCT). Logistic regression and univariate analyses were used to identify whether clinical characteristics or bone geometry variables were associated with fractures. RESULTS: Seventy individuals with SCI [mean age (standard deviation [SD]), 48.8 (11.5); 20 females] reported 19 fragility fractures. Individuals without fractures had significantly greater aBMD of the hip and knee regions and indices of bone geometry. Every SD decrease in aBMD of the distal femur and proximal tibia, trabecular volumetric bone mineral density, and polar moment of inertia was associated with fracture prevalence after adjusting for motor complete injury (odds ratio ranged from 3.2 to 6.1). CONCLUSION: Low knee aBMD and suboptimal bone geometry are significantly associated with fractures. Prospective studies are necessary to confirm the bone parameters reported to predict fracture risk in individuals with low bone mass and chronic SCI.
UNLABELLED: In this cross-sectional study, we found that areal bone mineral density (aBMD) at the knee and specific tibia bone geometry variables are associated with fragility fractures in men and women with chronic spinal cord injury (SCI). INTRODUCTION: Low aBMD of the hip and knee regions have been associated with fractures among individuals with chronic motor complete SCI; however, it is unclear whether these variables can be used to identify those at risk of fracture. In this cross-sectional study, we examined whether BMD and geometry measures are associated with lower extremity fragility fractures in individuals with chronic SCI. METHODS: Adults with chronic [duration of injury ≥ 2 years] traumatic SCI (C1-L1 American Spinal Cord Injury Association Impairment Scale A-D) reported post injury lower extremity fragility fractures. Dual-energy X-ray absorptiometry (DXA) was used to measure aBMD of the hip, distal femur, and proximal tibia regions, while bone geometry at the tibia was assessed using peripheral quantitative computed tomography (pQCT). Logistic regression and univariate analyses were used to identify whether clinical characteristics or bone geometry variables were associated with fractures. RESULTS: Seventy individuals with SCI [mean age (standard deviation [SD]), 48.8 (11.5); 20 females] reported 19 fragility fractures. Individuals without fractures had significantly greater aBMD of the hip and knee regions and indices of bone geometry. Every SD decrease in aBMD of the distal femur and proximal tibia, trabecular volumetric bone mineral density, and polar moment of inertia was associated with fracture prevalence after adjusting for motor complete injury (odds ratio ranged from 3.2 to 6.1). CONCLUSION: Low knee aBMD and suboptimal bone geometry are significantly associated with fractures. Prospective studies are necessary to confirm the bone parameters reported to predict fracture risk in individuals with low bone mass and chronic SCI.
Authors: Alexandra Papaioannou; Suzanne Morin; Angela M Cheung; Stephanie Atkinson; Jacques P Brown; Sidney Feldman; David A Hanley; Anthony Hodsman; Sophie A Jamal; Stephanie M Kaiser; Brent Kvern; Kerry Siminoski; William D Leslie Journal: CMAJ Date: 2010-10-12 Impact factor: 8.262
Authors: Armando Luis Negri; Roberto Barone; Carola Lombas; Cesar E Bogado; Jose Ruben Zanchetta Journal: Hemodial Int Date: 2006-10 Impact factor: 1.812
Authors: Jill M Slade; C Scott Bickel; Christopher M Modlesky; Sharmila Majumdar; Gary A Dudley Journal: Osteoporos Int Date: 2004-08-28 Impact factor: 4.507
Authors: Y Dionyssiotis; G Trovas; A Galanos; P Raptou; N Papaioannou; P Papagelopoulos; K Petropoulou; G P Lyritis Journal: J Musculoskelet Neuronal Interact Date: 2007 Jan-Mar Impact factor: 2.041
Authors: Yahtyng Sheu; Joseph M Zmuda; Robert M Boudreau; Moira A Petit; Kristine E Ensrud; Douglas C Bauer; Christopher L Gordon; Eric S Orwoll; Jane A Cauley Journal: J Bone Miner Res Date: 2011-01 Impact factor: 6.741
Authors: Jenna C Gibbs; Dany H Gagnon; Austin J Bergquist; Jasmine Arel; Tomas Cervinka; Rasha El-Kotob; Désirée B Maltais; Dalton L Wolfe; B Catharine Craven Journal: J Spinal Cord Med Date: 2017-07-13 Impact factor: 1.985
Authors: C M Cirnigliaro; M J Myslinski; M F La Fountaine; S C Kirshblum; G F Forrest; W A Bauman Journal: Osteoporos Int Date: 2016-12-05 Impact factor: 4.507
Authors: L Abderhalden; F M Weaver; M Bethel; H Demirtas; S Burns; J Svircev; H Hoenig; K Lyles; S Miskevics; L D Carbone Journal: Osteoporos Int Date: 2016-12-06 Impact factor: 4.507
Authors: Frances M Weaver; Bella Etingen; Marylou Guihan; Cara Ray; Michael Priebe; Stephen Burns; Laura Carbone Journal: J Spinal Cord Med Date: 2019-12-20 Impact factor: 1.985
Authors: Jenna C Gibbs; B Catharine Craven; Cameron Moore; Lehana Thabane; Jonathan D Adachi; Lora M Giangregorio Journal: Top Spinal Cord Inj Rehabil Date: 2015-11-16
Authors: T Cervinka; C L Lynch; L Giangregorio; J D Adachi; A Papaioannou; L Thabane; B C Craven Journal: Spinal Cord Date: 2017-06-13 Impact factor: 2.772
Authors: Chelsea A Pelletier; Frédéric S Dumont; Jean Leblond; Luc Noreau; Lora Giangregorio; B Catharine Craven Journal: Top Spinal Cord Inj Rehabil Date: 2014