Is rapid bone loss captured by bone shape in spinal cord injury patients?

D Varzi, S Coupaud, M Purcell, DB Allan, JS Gregory, RJ Barr

Research output: Contribution to journalConference Contribution

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Abstract

Introduction: Spinal Cord Injury (SCI) can trigger bone loss below the level of injury. Bone loss and fractures most commonly occur at the distal femur and proximal tibia and are associated with significantly increased morbidity. Bone loss following SCI has been shown to vary between 0 and 40% in the first year, with no current biomarkers to predict who will suffer severe bone loss. Standard osteoporosis treatments are risky for SCI patients and most effective in the early stages, therefore early identification of those at greatest risk is desirable. Active Shape Modelling (ASM) is a statistical technique for modelling bone morphology that predicts postmenopausal hip fractures. SCI can be considered an accelerated model of osteoporosis progression, and biomarkers for bone loss in SCI may be applicable to those at high risk of developing osteoporosis in the general population. This study investigated whether ASM predicts SCI-associated bone loss.Material and Methods: 25 patients with motor complete SCI (aged 16-76 years, 21 male and 4 female, 10 paraplegic and 15 tetraplegic) were scanned at the distal femur and proximal tibia using peripheral quantitative CT (Stratec Medizintechnik GmbH) at <5weeks, 4, 8 and 12 months post-injury. An ASM was made for each site. Links between 7 shape-modes (defined as standard deviations from the mean shape) and 12 month BMD loss were analysed using multiple linear regression (SPSS V21).Discussion: One mode from each ASM significantly predicted bone loss after adjustment for age (P < 0.05). High mode 4 femur scores showed a taller and narrower intercondylar notch. A +1 score was associated with an additional 6% BMD loss at 12 months. High tibia mode 1 scores represented a flatter tibial tuberosity. A +1score at baseline was associated with an additional 7% loss of BMD at 12 months. Conclusion: This is the first study to use ASM to predict bone loss. Baseline bone shape predicts 12-month bone loss in SCI patients. This imaging biomarker may help in early identification, treatment and prevention of SCI osteoporosis, with wider implications for postmenopausal osteoporosis.
Original languageEnglish
Article numberP10
Pages (from-to)S683
Number of pages1
JournalOsteoporosis International
Volume25
Issue number6 Supplement
DOIs
Publication statusPublished - 1 Nov 2014
EventOsteoporosis Conference 2014 - Birmingham, United Kingdom
Duration: 30 Nov 20142 Dec 2014

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Spinal Cord Injuries
Bone
Bone and Bones
Osteoporosis
Tibia
Femur
Biomarkers
Postmenopausal Osteoporosis
Bone Fractures
Hip Fractures
Wounds and Injuries
Linear Models
Linear regression
Morbidity
Imaging techniques
Therapeutics

Keywords

  • osteoporosis
  • spinal cord injury
  • rapid bone loss
  • bone shape

Cite this

Varzi, D., Coupaud, S., Purcell, M., Allan, DB., Gregory, JS., & Barr, RJ. (2014). Is rapid bone loss captured by bone shape in spinal cord injury patients? Osteoporosis International , 25(6 Supplement), S683. [P10]. https://doi.org/10.1007/s00198-014-2893-0
Varzi, D ; Coupaud, S ; Purcell, M ; Allan, DB ; Gregory, JS ; Barr, RJ. / Is rapid bone loss captured by bone shape in spinal cord injury patients?. In: Osteoporosis International . 2014 ; Vol. 25, No. 6 Supplement. pp. S683.
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abstract = "Introduction: Spinal Cord Injury (SCI) can trigger bone loss below the level of injury. Bone loss and fractures most commonly occur at the distal femur and proximal tibia and are associated with significantly increased morbidity. Bone loss following SCI has been shown to vary between 0 and 40{\%} in the first year, with no current biomarkers to predict who will suffer severe bone loss. Standard osteoporosis treatments are risky for SCI patients and most effective in the early stages, therefore early identification of those at greatest risk is desirable. Active Shape Modelling (ASM) is a statistical technique for modelling bone morphology that predicts postmenopausal hip fractures. SCI can be considered an accelerated model of osteoporosis progression, and biomarkers for bone loss in SCI may be applicable to those at high risk of developing osteoporosis in the general population. This study investigated whether ASM predicts SCI-associated bone loss.Material and Methods: 25 patients with motor complete SCI (aged 16-76 years, 21 male and 4 female, 10 paraplegic and 15 tetraplegic) were scanned at the distal femur and proximal tibia using peripheral quantitative CT (Stratec Medizintechnik GmbH) at <5weeks, 4, 8 and 12 months post-injury. An ASM was made for each site. Links between 7 shape-modes (defined as standard deviations from the mean shape) and 12 month BMD loss were analysed using multiple linear regression (SPSS V21).Discussion: One mode from each ASM significantly predicted bone loss after adjustment for age (P < 0.05). High mode 4 femur scores showed a taller and narrower intercondylar notch. A +1 score was associated with an additional 6{\%} BMD loss at 12 months. High tibia mode 1 scores represented a flatter tibial tuberosity. A +1score at baseline was associated with an additional 7{\%} loss of BMD at 12 months. Conclusion: This is the first study to use ASM to predict bone loss. Baseline bone shape predicts 12-month bone loss in SCI patients. This imaging biomarker may help in early identification, treatment and prevention of SCI osteoporosis, with wider implications for postmenopausal osteoporosis.",
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Varzi, D, Coupaud, S, Purcell, M, Allan, DB, Gregory, JS & Barr, RJ 2014, 'Is rapid bone loss captured by bone shape in spinal cord injury patients?', Osteoporosis International , vol. 25, no. 6 Supplement, P10, pp. S683. https://doi.org/10.1007/s00198-014-2893-0

Is rapid bone loss captured by bone shape in spinal cord injury patients? / Varzi, D; Coupaud, S; Purcell, M; Allan, DB; Gregory, JS; Barr, RJ.

In: Osteoporosis International , Vol. 25, No. 6 Supplement, P10, 01.11.2014, p. S683.

Research output: Contribution to journalConference Contribution

TY - JOUR

T1 - Is rapid bone loss captured by bone shape in spinal cord injury patients?

AU - Varzi, D

AU - Coupaud, S

AU - Purcell, M

AU - Allan, DB

AU - Gregory, JS

AU - Barr, RJ

N1 - The final publication is available at Springer via http://dx.doi.org/10.1007/s00198-014-2893-0

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Introduction: Spinal Cord Injury (SCI) can trigger bone loss below the level of injury. Bone loss and fractures most commonly occur at the distal femur and proximal tibia and are associated with significantly increased morbidity. Bone loss following SCI has been shown to vary between 0 and 40% in the first year, with no current biomarkers to predict who will suffer severe bone loss. Standard osteoporosis treatments are risky for SCI patients and most effective in the early stages, therefore early identification of those at greatest risk is desirable. Active Shape Modelling (ASM) is a statistical technique for modelling bone morphology that predicts postmenopausal hip fractures. SCI can be considered an accelerated model of osteoporosis progression, and biomarkers for bone loss in SCI may be applicable to those at high risk of developing osteoporosis in the general population. This study investigated whether ASM predicts SCI-associated bone loss.Material and Methods: 25 patients with motor complete SCI (aged 16-76 years, 21 male and 4 female, 10 paraplegic and 15 tetraplegic) were scanned at the distal femur and proximal tibia using peripheral quantitative CT (Stratec Medizintechnik GmbH) at <5weeks, 4, 8 and 12 months post-injury. An ASM was made for each site. Links between 7 shape-modes (defined as standard deviations from the mean shape) and 12 month BMD loss were analysed using multiple linear regression (SPSS V21).Discussion: One mode from each ASM significantly predicted bone loss after adjustment for age (P < 0.05). High mode 4 femur scores showed a taller and narrower intercondylar notch. A +1 score was associated with an additional 6% BMD loss at 12 months. High tibia mode 1 scores represented a flatter tibial tuberosity. A +1score at baseline was associated with an additional 7% loss of BMD at 12 months. Conclusion: This is the first study to use ASM to predict bone loss. Baseline bone shape predicts 12-month bone loss in SCI patients. This imaging biomarker may help in early identification, treatment and prevention of SCI osteoporosis, with wider implications for postmenopausal osteoporosis.

AB - Introduction: Spinal Cord Injury (SCI) can trigger bone loss below the level of injury. Bone loss and fractures most commonly occur at the distal femur and proximal tibia and are associated with significantly increased morbidity. Bone loss following SCI has been shown to vary between 0 and 40% in the first year, with no current biomarkers to predict who will suffer severe bone loss. Standard osteoporosis treatments are risky for SCI patients and most effective in the early stages, therefore early identification of those at greatest risk is desirable. Active Shape Modelling (ASM) is a statistical technique for modelling bone morphology that predicts postmenopausal hip fractures. SCI can be considered an accelerated model of osteoporosis progression, and biomarkers for bone loss in SCI may be applicable to those at high risk of developing osteoporosis in the general population. This study investigated whether ASM predicts SCI-associated bone loss.Material and Methods: 25 patients with motor complete SCI (aged 16-76 years, 21 male and 4 female, 10 paraplegic and 15 tetraplegic) were scanned at the distal femur and proximal tibia using peripheral quantitative CT (Stratec Medizintechnik GmbH) at <5weeks, 4, 8 and 12 months post-injury. An ASM was made for each site. Links between 7 shape-modes (defined as standard deviations from the mean shape) and 12 month BMD loss were analysed using multiple linear regression (SPSS V21).Discussion: One mode from each ASM significantly predicted bone loss after adjustment for age (P < 0.05). High mode 4 femur scores showed a taller and narrower intercondylar notch. A +1 score was associated with an additional 6% BMD loss at 12 months. High tibia mode 1 scores represented a flatter tibial tuberosity. A +1score at baseline was associated with an additional 7% loss of BMD at 12 months. Conclusion: This is the first study to use ASM to predict bone loss. Baseline bone shape predicts 12-month bone loss in SCI patients. This imaging biomarker may help in early identification, treatment and prevention of SCI osteoporosis, with wider implications for postmenopausal osteoporosis.

KW - osteoporosis

KW - spinal cord injury

KW - rapid bone loss

KW - bone shape

UR - https://www.nos.org.uk/health-professionals/oesteoporosis-conference

UR - http://link.springer.com/journal/198

U2 - 10.1007/s00198-014-2893-0

DO - 10.1007/s00198-014-2893-0

M3 - Conference Contribution

VL - 25

SP - S683

JO - Osteoporosis International

JF - Osteoporosis International

SN - 0937-941X

IS - 6 Supplement

M1 - P10

ER -