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01-03-2017 | Original Article

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

Authors: L. Abderhalden, F. M. Weaver, M. Bethel, H. Demirtas, S. Burns, J. Svircev, H. Hoenig, K. Lyles, S. Miskevics, L. D. Carbone

Published in: Osteoporosis International | Issue 3/2017

Abstract

Summary

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.

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Title: Dual-energy X-ray absorptiometry and fracture prediction in patients with spinal cord injuries and disorders
Authors: L. Abderhalden
F. M. Weaver
M. Bethel
H. Demirtas
S. Burns
J. Svircev
H. Hoenig
K. Lyles
S. Miskevics
L. D. Carbone
Publication date: 01-03-2017
Publisher: Springer London
Published in: Osteoporosis International / Issue 3/2017
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-016-3841-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Summary

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

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