Bone morphology of the femur and tibia captured by statistical shape modelling predicts rapid bone loss in acute spinal cord injury patients

Delaram Varzi, Sylvie A.F. Coupaud, Mariel Purcell, David B. Allan, Jennifer S. Gregory, Rebecca J. Barr

Research output: Contribution to journalArticle

12 Citations (Scopus)
82 Downloads (Pure)

Abstract

After spinal cord injury (SCI), bone loss in the paralysed limbs progresses at variable rates. Decreases in bone mineral density (BMD) in the first year range from 1% (slow) to 40% (rapid). In chronic SCI, fragility fractures commonly occur around the knee, with significant associated morbidity. Osteoporosis treatments await full evaluation in SCI, but should be initiated early and targeted towards patients exhibiting rapid bone loss. The potential to predict rapid bone loss from a single bone scan within weeks of a SCI was investigated using statistical shape modelling (SSM) of bone morphology, hypothesis: baseline bone shape predicts bone loss at 12-months post-injury at fracture-prone sites. In this retrospective cohort study 25 SCI patients (median age, 33 years) were scanned at the distal femur and proximal tibia using peripheral Quantitative Computed Tomography at <5 weeks (baseline), 4, 8 and 12 months post-injury. An SSM was made for each bone. Links between the baseline shape-modes and 12-month total and trabecular BMD loss were analysed using multiple linear regression. One mode fromeach SSMsignificantly predicted bone loss (age-adjusted P <0.05 R^2=0.37–0.61) at baseline. An elongated intercondylar femoral notch (femur mode 4, +1 SD from the mean) was associated with 8.2% additional loss of femoral trabecular BMD at 12-months. A more concave posterior tibial fossa (tibia mode 3, +1 SD) was associated with 9.4% additional 12-month tibial trabecular BMD loss. Baseline bone shape determined from a single bone scan is a valid imaging biomarker for the prediction of 12-month bone loss in SCI patients.
Original languageEnglish
Pages (from-to)495-501
Number of pages7
JournalBONE
Volume81
Early online date2 Sep 2015
DOIs
Publication statusPublished - Dec 2015

Fingerprint

Tibia
Spinal Cord Injuries
Femur
Bone
Bone and Bones
Bone Density
Minerals
Thigh
Wounds and Injuries
Osteoporosis
Linear Models
Knee
Biomarkers
Cohort Studies
Extremities
Retrospective Studies
Tomography
Linear regression
Morbidity

Keywords

  • spinal cord injury
  • osteoporosis
  • tibia
  • femur
  • pQCT
  • statistical shape model

Cite this

Varzi, Delaram ; Coupaud, Sylvie A.F. ; Purcell, Mariel ; Allan, David B. ; Gregory, Jennifer S. ; Barr, Rebecca J. / Bone morphology of the femur and tibia captured by statistical shape modelling predicts rapid bone loss in acute spinal cord injury patients. In: BONE. 2015 ; Vol. 81. pp. 495-501.
@article{22690a4bfe524360bf54a3624c067df6,
title = "Bone morphology of the femur and tibia captured by statistical shape modelling predicts rapid bone loss in acute spinal cord injury patients",
abstract = "After spinal cord injury (SCI), bone loss in the paralysed limbs progresses at variable rates. Decreases in bone mineral density (BMD) in the first year range from 1{\%} (slow) to 40{\%} (rapid). In chronic SCI, fragility fractures commonly occur around the knee, with significant associated morbidity. Osteoporosis treatments await full evaluation in SCI, but should be initiated early and targeted towards patients exhibiting rapid bone loss. The potential to predict rapid bone loss from a single bone scan within weeks of a SCI was investigated using statistical shape modelling (SSM) of bone morphology, hypothesis: baseline bone shape predicts bone loss at 12-months post-injury at fracture-prone sites. In this retrospective cohort study 25 SCI patients (median age, 33 years) were scanned at the distal femur and proximal tibia using peripheral Quantitative Computed Tomography at <5 weeks (baseline), 4, 8 and 12 months post-injury. An SSM was made for each bone. Links between the baseline shape-modes and 12-month total and trabecular BMD loss were analysed using multiple linear regression. One mode fromeach SSMsignificantly predicted bone loss (age-adjusted P <0.05 R^2=0.37–0.61) at baseline. An elongated intercondylar femoral notch (femur mode 4, +1 SD from the mean) was associated with 8.2{\%} additional loss of femoral trabecular BMD at 12-months. A more concave posterior tibial fossa (tibia mode 3, +1 SD) was associated with 9.4{\%} additional 12-month tibial trabecular BMD loss. Baseline bone shape determined from a single bone scan is a valid imaging biomarker for the prediction of 12-month bone loss in SCI patients.",
keywords = "spinal cord injury, osteoporosis, tibia, femur, pQCT, statistical shape model",
author = "Delaram Varzi and Coupaud, {Sylvie A.F.} and Mariel Purcell and Allan, {David B.} and Gregory, {Jennifer S.} and Barr, {Rebecca J.}",
year = "2015",
month = "12",
doi = "10.1016/j.bone.2015.08.026",
language = "English",
volume = "81",
pages = "495--501",
journal = "BONE",
issn = "8756-3282",

}

Bone morphology of the femur and tibia captured by statistical shape modelling predicts rapid bone loss in acute spinal cord injury patients. / Varzi, Delaram; Coupaud, Sylvie A.F.; Purcell, Mariel; Allan, David B.; Gregory, Jennifer S.; Barr, Rebecca J.

In: BONE, Vol. 81, 12.2015, p. 495-501.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Bone morphology of the femur and tibia captured by statistical shape modelling predicts rapid bone loss in acute spinal cord injury patients

AU - Varzi, Delaram

AU - Coupaud, Sylvie A.F.

AU - Purcell, Mariel

AU - Allan, David B.

AU - Gregory, Jennifer S.

AU - Barr, Rebecca J.

PY - 2015/12

Y1 - 2015/12

N2 - After spinal cord injury (SCI), bone loss in the paralysed limbs progresses at variable rates. Decreases in bone mineral density (BMD) in the first year range from 1% (slow) to 40% (rapid). In chronic SCI, fragility fractures commonly occur around the knee, with significant associated morbidity. Osteoporosis treatments await full evaluation in SCI, but should be initiated early and targeted towards patients exhibiting rapid bone loss. The potential to predict rapid bone loss from a single bone scan within weeks of a SCI was investigated using statistical shape modelling (SSM) of bone morphology, hypothesis: baseline bone shape predicts bone loss at 12-months post-injury at fracture-prone sites. In this retrospective cohort study 25 SCI patients (median age, 33 years) were scanned at the distal femur and proximal tibia using peripheral Quantitative Computed Tomography at <5 weeks (baseline), 4, 8 and 12 months post-injury. An SSM was made for each bone. Links between the baseline shape-modes and 12-month total and trabecular BMD loss were analysed using multiple linear regression. One mode fromeach SSMsignificantly predicted bone loss (age-adjusted P <0.05 R^2=0.37–0.61) at baseline. An elongated intercondylar femoral notch (femur mode 4, +1 SD from the mean) was associated with 8.2% additional loss of femoral trabecular BMD at 12-months. A more concave posterior tibial fossa (tibia mode 3, +1 SD) was associated with 9.4% additional 12-month tibial trabecular BMD loss. Baseline bone shape determined from a single bone scan is a valid imaging biomarker for the prediction of 12-month bone loss in SCI patients.

AB - After spinal cord injury (SCI), bone loss in the paralysed limbs progresses at variable rates. Decreases in bone mineral density (BMD) in the first year range from 1% (slow) to 40% (rapid). In chronic SCI, fragility fractures commonly occur around the knee, with significant associated morbidity. Osteoporosis treatments await full evaluation in SCI, but should be initiated early and targeted towards patients exhibiting rapid bone loss. The potential to predict rapid bone loss from a single bone scan within weeks of a SCI was investigated using statistical shape modelling (SSM) of bone morphology, hypothesis: baseline bone shape predicts bone loss at 12-months post-injury at fracture-prone sites. In this retrospective cohort study 25 SCI patients (median age, 33 years) were scanned at the distal femur and proximal tibia using peripheral Quantitative Computed Tomography at <5 weeks (baseline), 4, 8 and 12 months post-injury. An SSM was made for each bone. Links between the baseline shape-modes and 12-month total and trabecular BMD loss were analysed using multiple linear regression. One mode fromeach SSMsignificantly predicted bone loss (age-adjusted P <0.05 R^2=0.37–0.61) at baseline. An elongated intercondylar femoral notch (femur mode 4, +1 SD from the mean) was associated with 8.2% additional loss of femoral trabecular BMD at 12-months. A more concave posterior tibial fossa (tibia mode 3, +1 SD) was associated with 9.4% additional 12-month tibial trabecular BMD loss. Baseline bone shape determined from a single bone scan is a valid imaging biomarker for the prediction of 12-month bone loss in SCI patients.

KW - spinal cord injury

KW - osteoporosis

KW - tibia

KW - femur

KW - pQCT

KW - statistical shape model

U2 - 10.1016/j.bone.2015.08.026

DO - 10.1016/j.bone.2015.08.026

M3 - Article

VL - 81

SP - 495

EP - 501

JO - BONE

JF - BONE

SN - 8756-3282

ER -