Osteoporosis in patients with paralysis after spinal cord injury - A crosssectional study in 46 male patients with dual-energy X-ray absorptiometry

In a cross-sectional study, 46 male patients with paralysis after spinal co rd injury (average age 32 years; injuries sustained from 1 to 26 years ago; 33 Frankel A, 13 Frankel B, C, D) were examined clinically and by dual-ene rgy X-ray absorptiometry (DEXA). Their bone mineral density (BMD) values we re compared with age-related controls and correlated to clinical parameters . BMD was reduced in the proximal femur (p < 0.05) and the distal forearm ( p < 0.05), but not in the lumbar spine. Demineralisation was influenced in the proximal femur (Z-score -2.95) by immobilisation after surgical treatme nt. Patients suffering from complete lesions had significantly lower BMD in the lumbar spine (-1.47) compared with patients with incomplete lesions (0.02). BMD was not significantly influenced by the level of the lesion and the ambulatory status. Long-term monitoring showed significant demineralisa tion in the proximal femur (r = -0.36) and the distal forearm (r = -0.4), b ut not in the lumbar spine (r = -0.21). By correlating BMD with clinical pa rameters, it can be deduced that, firstly, immobilisation after surgical tr eatment should be reduced to a minimum; secondly, that every effort must be expended to prevent turning an incomplete into a complete lesion; and fina lly, that rehabilitation treatment should be lifelong.