• D Sabo, S Blaich, W Wenz, M Hohmann, M Loew, and H J Gerner.
• Stiftung Orthopädische Universitätsklinik Heidelberg, Abteilung Orthopädie I, Germany.
• Arch Orthop Trauma Surg. 2001 Jan 1; 121 (1-2): 75-8.

AbstractIn a cross-sectional study, 46 male patients with paralysis after spinal cord 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-energy X-ray absorptiometry (DEXA). Their bone mineral density (BMD) values were 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 treatment. 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 demineralisation in the proximal femur (r = -0.36) and the distal forearm (r = -0.4), but not in the lumbar spine (r = -0.21). By correlating BMD with clinical parameters, it can be deduced that, firstly, immobilisation after surgical treatment should be reduced to a minimum; secondly, that every effort must be expended to prevent turning an incomplete into a complete lesion; and finally, that rehabilitation treatment should be lifelong.

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