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Structural analysis of the human tibia in men with spinal cord injury by tomographic (pQCT) serial scans

Rittweger, Jörn and Goosey-Tolfrey, Vicky and Cointry, Gustavo and Ferretti, Jose Luis (2010) Structural analysis of the human tibia in men with spinal cord injury by tomographic (pQCT) serial scans. Bone, 47, pp. 511-518.

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Abstract

Spinal cord injury (SCI), as a primarily neurological disorder that causes muscular atrophy, is well known to be associated with sub-lesional bone losses. These losses are more pronounced from epiphyseal than from diaphyseal regions. We hypothesized that this discrepancy may be explained by anatomical variation in endocortical circumference. Nine men who had attracted SCI 9 to 32 (mean 21.4) years prior to study inclusion were matched to able bodied control (Ctrl) people by age, height and weight. Serial scans by peripheral quantitative computed tomography were obtained from the tibia at steps corresponding to 5%-steps of the tibias length (s05 to s95, from distal to the proximal end of the tibia). As expected, SCI people had lower total bone mineral content (vBMC.tot) than able bodied control people (Pb0.001 at all sites). This group difference (��vBMC.tot) was more pronounced at the distal and proximal tibia than in the shaft (Pb0.001), and itamounted to 51% at s05, to 22% at s40, and to 47% at s95. Both endocortical and periosteal circumference were better predictors of ��vBMC.tot (R2=0.98 and R2=0.97, respectively; Pb0.001 in both cases) than vBMC.tot (R2=0.58, Pb0.001), suggesting that anatomical variation in geometry, rather than in bone mass can explain differential rates of bone loss after SCI. Moreover, the s04:s38 ratio in vBMC.tot was found to be 1.00 (95% confidence interval: 0.95�1.05) in the Ctrl group, and 0.63 in the SCI group (Pb0.001, 95% confidence interval: 0.54�0.68). These findings offer a rationale to account for the discrepancy between epiphyseal and diaphyseal bone losses following SCI. The suggestion is that the bone adaptive responses involved are limited in time, and that the reduced surface:volume ratio constitutes a limitwithin the available timewindow, in particular in the diaphysis. Finally, the drastically reduced s04:s38 vBMC.tot ratio observed in the SCI group in this study provides a rationale to scrutinize this Capozza index also in other studies as a general indicator of immobilisation-induced bone loss.

Document Type:Article
Title:Structural analysis of the human tibia in men with spinal cord injury by tomographic (pQCT) serial scans
Authors:
AuthorsInstitution or Email of Authors
Rittweger, Jörnjoern.rittweger@dlr.de
Goosey-Tolfrey, VickyV.L.Tolfrey@lboro.ac.uk
Cointry, Gustavogcointry@express.com.ar
Ferretti, Jose Luisjlferretti@arnet.com.ar
Date:2010
Journal or Publication Title:Bone
Refereed publication:Yes
In Open Access:No
In SCOPUS:Yes
In ISI Web of Science:Yes
Volume:47
Page Range:pp. 511-518
Status:Published
Keywords:Immobilization Bone biomechanics Disuse-induced osteopenia Bone density Bone geometry
HGF - Research field:Aeronautics, Space and Transport (old)
HGF - Program:Space (old)
HGF - Program Themes:W FR - Forschung unter Weltraumbedingungen (old)
DLR - Research area:Space
DLR - Program:W FR - Forschung unter Weltraumbedingungen
DLR - Research theme (Project):W - Vorhaben Integrative Studien (old)
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine > Space Physiology
Deposited By: Jörn Rittweger
Deposited On:31 Aug 2010 14:47
Last Modified:12 Dec 2013 21:00

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