The effects of long-term immobilization on the histomorphology of human cortical bone.

The cortical bone histomorphometrics, total visible osteon density, and mean osteonal cross-sectional area were determined for the major long bones and sixth ribs of two individuals with neurological deficit. One was a multiple sclerosis patient who had been in a wheelchair for 15 years. The other was a quadriplegic as a result of poliomyelitis. Statistically significant differences in osteon densities occurred only in the case of the quadriplegic. Nevertheless, in that subject, the total visible osteon densities for bones of the right arm were not statistically different from these of their age-matched (control) radii. Medical history records revealed that there had been partial use of this limb. These results support the belief that mechanical stress is an important factor in the maintenance of normal cortical bone remodeling. In addition, since there were subnormal osteon densities and normal mean osteonal cross-sectional areas, immobilization appears to be characterized by reduced activation frequency with a normal amount of bone turnover per BMU.