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Vol. 37 No. 2, March/April 2000

Bone mineral and geometric changes through the femur with immobilization due to spinal cord injury

B.J. Kiratli, PhD; A.E. Smith, BA, PA; T. Nauenberg, MSE, MD; C.F. Kallfelz, MSE, Eng; I. Perkash, MD

Spinal Cord Injury Center, VA Palo Alto Health Care System, Palo Alto, CA 94304; Design Division and Biomechanical Engineering Division, Mechanical Engineering Department, Stanford University, Stanford, CA 94305

Abstract — This cross-sectional study describes bone mineral and geometric properties of the midshaft and distal femur in a control population and examines effects of immobilization due to spinal cord injury (SCI) at these skeletal sites. The subject populations were comprised of 118 ambulatory adults (59 men and 59 women) and 246 individuals with SCI (239 men and 7 women); 30 of these were considered to have acute injury (SCI duration <1 year). Bone mineral density (BMD) was assessed at the femoral neck, and midshaft and distal femur by dual energy absorptiometry. Geometric properties, specifically cortical area, polar moment of inertia, and polar section modulus, were estimated at the midshaft from cortical dimensions obtained by concurrent radiography. Reduction in BMD was noted in all femoral regions (27%, 25%, and 43% for femoral neck, midshaft, and distal femur, respectively) compared with controls. In contrast, although endosteal diameter was enlarged, geometric properties were not significantly reduced in the midshaft attributable to the age-related increase in periosteal diameter. These results suggest that simultaneous assessment of bone mineral and geometric properties may improve clinically relevant evaluation of skeletal status.

Key words: bone mineral density, DXA, femur, osteoporosis, spinal cord injury.

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