Ponzano Matteo, Blencowe Lindsie, Giangregorio Lora M, Craven B Catharine
School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC, Canada.
International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC), The University of British Columbia, Vancouver, BC, Canada.
Top Spinal Cord Inj Rehabil. 2024 Fall;30(4):14-23. doi: 10.46292/sci24-00014. Epub 2024 Nov 28.
To describe lumbar spine (LS) trabecular bone score (TBS) values after SCI, and to explore the differences in fractures risk assessment between FRAX® and TBS-adjusted FRAX® in individuals living with chronic SCI.
Baseline dual-energy x-ray absorptiometry (DXA) scans from an established cohort were acquired using a Hologic Discovery QDR 4500. TBS measurements were performed using the TBS iNsight software version 2.1.2.0. A Welch's t-test was performed to explore differences in TBS, FRAX®, and TBS-adjusted FRAX® between men and women, between participants ≤49 years and ≥50 years, and between subgroups with and without history of fracture and with complete and incomplete injury.
We analyzed 37 scans; the mean TBS was 1.336 ± 0.107. The mean 10-year fracture risk was 8.8% ± 11.4% for major osteoporotic fracture and 4.0% ± 10.8% for hip fracture according to FRAX®, and 6.6% ± 2.8% for major osteoporotic fracture and 2.8% ± 6.7% for hip fractures according to TBS-adjusted FRAX®. The 10-year fracture risk for major osteoporotic fractures was higher in individuals with a prior fragility fracture compared to those without, according to FRAX® ( = .033) and TBS-adjusted FRAX® ( = .001).
Over a half of our sample presented a partially degraded bone microarchitecture based on TBS. TBS was not different between people with motor complete and motor incomplete injury or with and without prior fragility fracture. Future studies are needed to define the clinical relevance of TBS and TBS-adjusted FRAX® in people with chronic SCI.
描述脊髓损伤（SCI）后腰椎（LS）小梁骨评分（TBS）值，并探讨FRAX®与经TBS调整的FRAX®在慢性SCI患者骨折风险评估中的差异。
使用Hologic Discovery QDR 4500对既定队列的基线双能X线吸收法（DXA）扫描进行采集。使用TBS iNsight软件版本2.1.2.0进行TBS测量。采用韦尔奇t检验探讨男性与女性之间、年龄≤49岁与≥50岁的参与者之间，以及有骨折史和无骨折史、完全损伤和不完全损伤亚组之间TBS、FRAX®和经TBS调整的FRAX®的差异。
我们分析了37次扫描；平均TBS为1.336±0.107。根据FRAX®，主要骨质疏松性骨折的平均10年骨折风险为8.8%±11.4%，髋部骨折为4.0%±10.8%；根据经TBS调整的FRAX®，主要骨质疏松性骨折为6.6%±2.8%，髋部骨折为2.8%±6.7%。根据FRAX®（P = 0.033）和经TBS调整的FRAX®（P = 0.001），有既往脆性骨折的个体发生主要骨质疏松性骨折的10年骨折风险高于无既往脆性骨折的个体。
基于TBS，我们样本中超过一半的人呈现出部分退化的骨微结构。运动完全损伤和运动不完全损伤的人或有和无既往脆性骨折的人之间TBS无差异。需要进一步研究来确定TBS和经TBS调整的FRAX®在慢性SCI患者中的临床相关性。
