Results from bone mineral density scans in twenty-two complete lesion paraplegics

Study design: The bone mineral density (BMD) in 22 male subjects with compl ete lesion paraplegia sustained 1.8 to 27 years previously was measured. Th e measurements were used in screening each subject for a research programme investigating the restoration of standing using functional electrical stim ulation (FES). Objectives: To assess the extent of bone loss in this group of subjects and correlation to age, time post-injury and level of lesion. Setting: District General Hospital in the UK. Methods: BMD was measured by dual energy X-ray absorptiometry (DEXA) in the lumbar spine and femoral neck and expressed as an indirect index to an age matched 'normal' population. Fracture risk was described from this score u sing published data indicating that the risk increased with each standard d eviation difference from the 'normal' mean. Results: The bone density in the lumbar spine was better preserved than in the femoral neck. BMD in the lumbar spine was found to be greater than the mean from the age matched population in 57.1% of subjects. Bone loss at the femoral neck suggested that 81.8% of the subjects were at increased risk o f fracture, but only 22.7% were at a high risk. No correlation was found be tween BMD at the lumbar spine or the femoral neck and age, lesion level or time post-injury. Conclusion: The study indicates that further investigation into baseline BM D values for the SCI population is required to improve information provided to patients and assessment of fracture risk on an individual basis. Sponsorship: U.K. Medical Research Council and the Wellcome Trust.