Choi Hyehoon, Chang So-Youn, Yoo Jaewan, Lim Seong Hoon, Hong Bo Young, Kim Joon Sung
Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Department of Rehabilitation Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
Ann Rehabil Med. 2021 Feb;45(1):1-6. doi: 10.5535/arm.20169. Epub 2021 Feb 9.
To investigate the correlation between bone mineral density (BMD) and duration of injury in individuals with spinal cord injury (SCI).
Patients with SCI who visited the outpatient department between January 2009 and January 2019 were enrolled. Patients' most recent dual energy X-ray absorptiometry images were reviewed. According to the 2007 International Society for Clinical Densitometry guidelines, vertebrae with a local structural change were excluded when deriving spine BMD. If one or no vertebra is suitable for evaluation, spine BMD was judged as "improper for assessment". Correlation analysis was performed between duration from injury and BMD Z-scores of the hip and spine.
Among 83 individuals with SCI, the spines of 44 were judged as improper for assessment. The correlation analysis showed a significant negative relationship between the duration from injury and femur neck BMD (r=-0.40, p<0.01) and total proximal femur BMD (r=-0.39, p<0.01). However, no significant correlation was found between the duration from injury and spine BMD Z-score.
The duration of SCI correlated with hip BMD, but not with spine BMD. Further, more than half of the individuals with SCI could not undergo spinal assessment due to local structural changes. Therefore, spine BMD measurement is not an appropriate method for predicting future fracture risk in those with SCI.
探讨脊髓损伤(SCI)患者骨密度(BMD)与损伤持续时间之间的相关性。
纳入2009年1月至2019年1月期间到门诊就诊的SCI患者。回顾患者最近的双能X线吸收测定图像。根据2007年国际临床骨密度测量学会指南,推导脊柱骨密度时排除有局部结构改变的椎体。如果一个或没有椎体适合评估,则将脊柱骨密度判定为“评估不当”。对损伤持续时间与髋部和脊柱的骨密度Z值进行相关性分析。
在83例SCI患者中,44例的脊柱被判定为评估不当。相关性分析显示,损伤持续时间与股骨颈骨密度(r=-0.40,p<0.01)和股骨近端总骨密度(r=-0.39,p<0.01)之间存在显著负相关。然而,损伤持续时间与脊柱骨密度Z值之间未发现显著相关性。
SCI的持续时间与髋部骨密度相关,但与脊柱骨密度无关。此外,超过一半的SCI患者由于局部结构改变无法进行脊柱评估。因此,脊柱骨密度测量不是预测SCI患者未来骨折风险的合适方法。