Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada.
McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada.
J Clin Densitom. 2019 Apr-Jun;22(2):249-256. doi: 10.1016/j.jocd.2018.04.002. Epub 2018 Apr 24.
Rapid declines in bone mineral density (BMD) at the knee after spinal cord injury (SCI) are associated with an increased risk of fracture. Evaluation of bone quality using the trabecular bone score (TBS) may provide a complimentary measure to BMD assessment to examine bone health and fracture risk after SCI. The purpose of this study was to assess bone mineral density (BMD) and trabecular bone score (TBS) at the knee in individuals with and without SCI. Nine individuals with complete SCI (mean time since SCI 2.9 ± 3.8 yr) and 9 non-SCI controls received dual-energy X-ray absorptiometry scans of the right knee using the lumbar spine protocol. BMD and TBS were quantified at epiphyseal, metaphyseal, diaphyseal, and total bone regions of the distal femur and proximal tibia. Individuals with SCI illustrated significantly lower total BMD at the distal femur (23%; p = 0.029) and proximal tibia (19%; p = 0.02) when compared with non-SCI controls. Despite these marked differences in BMD from both locations, significant differences in total TBS were observed at the distal femur only (6%; p = 0.023). The observed differences in total BMD and TBS could be attributed to reductions in epiphyseal rather than metaphyseal or diaphysis measurements. The relationship between TBS and duration of SCI was well explained by a logarithmic trend at the distal femoral epiphysis (r = 0.54, p = 0.025). The logarithmic trend would predict that after 3 yr of SCI, TBS would be approximately 6% lower than the non-SCI controls. Further evaluation is needed to determine if TBS measures at the knee provide important information about bone quality that is not captured by traditional BMD.
脊髓损伤（SCI）后膝关节骨密度（BMD）迅速下降与骨折风险增加有关。使用骨小梁评分（TBS）评估骨质量可能为 BMD 评估提供补充措施，以检查 SCI 后的骨健康和骨折风险。本研究的目的是评估有和无 SCI 的个体膝关节的骨矿物质密度（BMD）和骨小梁评分（TBS）。9 名完全性 SCI 患者（SCI 后时间平均为 2.9±3.8 年）和 9 名非 SCI 对照者接受了右侧膝关节双能 X 射线吸收法扫描，使用腰椎方案。在远端股骨和近端胫骨的骺、干骺、骨干和总骨区域量化了 BMD 和 TBS。与非 SCI 对照组相比，SCI 患者的远端股骨（23%；p=0.029）和近端胫骨（19%；p=0.02）的总 BMD 显著降低。尽管这两个部位的 BMD 存在显著差异，但仅在远端股骨处观察到总 TBS 的显著差异（6%；p=0.023）。远端股骨 TBS 和 SCI 持续时间之间的关系很好地用对数趋势来解释（远端股骨骺 r=0.54，p=0.025）。对数趋势预测，在 SCI 后 3 年，TBS 将比非 SCI 对照组低约 6%。需要进一步评估以确定膝关节处的 TBS 测量值是否提供了有关骨质量的重要信息，这些信息无法通过传统的 BMD 捕获。
