Dual-energy X-ray absorptiometry and fracture prediction in patients with spinal cord injuries and disorders Journal Article

Authors: Abderhalden, L; Weaver, F M; Bethel, M; Demirtas, H; Burns, S; Svircev, J; Hoenig, H; Lyles, K; Miskevics, S; Carbone, L D
Article Title: Dual-energy X-ray absorptiometry and fracture prediction in patients with spinal cord injuries and disorders
Abstract: Low T-scores at the hip predict incident fractures in persons with a SCI. INTRODUCTION: Persons with a spinal cord injury (SCI) have substantial morbidity and mortality following osteoporotic fractures. The objective of this study was to determine whether dual-energy X-ray absorptiometry (DXA) measurements predict osteoporotic fractures in this population. METHODS: A retrospective historical analysis that includes patients (n = 552) with a SCI of at least 2 years duration who had a DXA performed and were in the VA Spinal Cord Disorders Registry from fiscal year (FY) 2002-2012 was performed. RESULTS: The majority of persons (n = 455, 82%) had a diagnosis of osteoporosis or osteopenia, with almost half having osteoporosis. BMD and T-scores at the lumbar spine were not significantly associated with osteoporotic fractures (p > 0.48) for both. In multivariable analyses, osteopenia (OR = 4.75 95% CI 1.23-17.64) or osteoporosis (OR = 4.31, 95% CI 1.15-16.23) compared with normal BMD was significantly associated with fractures and higher T-scores at the hip were inversely associated with fractures (OR 0.73 (95% CI 0.57-0.92)). There was no significant association of T-scores or World Health Organization (WHO) classification with incident fractures in those with complete SCI (p > 0.15 for both). CONCLUSION: The majority (over 80%) of individuals with a SCI have osteopenia or osteoporosis. DXA-derived measurements at the hip, but not the lumbar spine, predict fracture risk in persons with a SCI. WHO-derived bone density categories may be useful in classifying fracture risk in persons with a SCI.
Keywords: Spinal Cord Injury; fractures; Osteoporosis; Public Health Services; Dual-energy X-ray absorptiometry
Journal Title: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Volume: 28
Issue: 3
ISSN: 1433-2965; 0937-941X
Publisher: Unknown  
Journal Place: England
Date Published: 2017
Start Page: 925
End Page: 934
Language: eng
Notes: LR: 20170208; JID: 9100105; OTO: NOTNLM; 2016/05/05 [received]; 2016/11/11 [accepted]; ppublish
LUC Authors
  1. Frances M Weaver
    53 Weaver