Measurement of Bone: Diagnosis of SCI-Induced Osteoporosis and Fracture Risk Prediction

Top Spinal Cord Inj Rehabil. 2015 Fall;21(4):267-74. doi: 10.1310/sci2104-267. Epub 2015 Nov 16.

Abstract

Background: Spinal cord injury (SCI) is associated with a rapid loss of bone mass, resulting in severe osteoporosis and a 5- to 23-fold increase in fracture risk. Despite the seriousness of fractures in SCI, there are multiple barriers to osteoporosis diagnosis and wide variations in treatment practices for SCI-induced osteoporosis.

Methods: We review the biological and structural changes that are known to occur in bone after SCI in the context of promoting future research to prevent or reduce risk of fracture in this population. We also review the most commonly used methods for assessing bone after SCI and discuss the strengths, limitations, and clinical applications of each method.

Conclusions: Although dual-energy x-ray absorptiometry assessments of bone mineral density may be used clinically to detect changes in bone after SCI, 3-dimensional methods such as quantitative CT analysis are recommended for research applications and are explained in detail.

Keywords: QCT; bone density; finite element analysis; fracture; osteoporosis; rehabilitation medicine; spinal cord injury.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Absorptiometry, Photon / methods
  • Bone Density*
  • Bone and Bones / diagnostic imaging
  • Bone and Bones / metabolism*
  • Fractures, Bone / etiology*
  • Fractures, Bone / metabolism
  • Humans
  • Osteoporosis / diagnosis*
  • Osteoporosis / diagnostic imaging
  • Osteoporosis / etiology
  • Osteoporosis / metabolism
  • Spinal Cord Injuries / complications*
  • Tomography, X-Ray Computed / methods