Relationships between T-scores at the hip and bone mineral density at the distal femur and proximal tibia in persons with spinal cord injury

Model System:

SCI

Reference Type:

Journal article

Accession No.:

J84727

Journal:

Journal of Spinal Cord Medicine - JSCM (formerly Journal of the American Paraplegia Society)

Year, Volume, Issue, Page(s):

2020 , 43, 5, 685-695

Publication Website:

Abstract:

Study identified T-score values at the total hip (TH) and femoral neck (FN) that correspond to the cutoff value of <0.60 g/cm2 for heightened risk of fracture at the distal femur (DF) and proximal tibia (PT) in people with spinal cord injury (SCI). DXA derived areal BMD (aBMD) and T-score of the DF, PT, TH, and FN were obtained from 105 unique individuals with SCI. Analyses revealed that the aBMD at the DF and PT regions were predictors of T-scores at the TH and FN. Using the DF and PT aBMD of 0.60 g/cm2 as a value below which fractures were more likely to occur, the predicted T-score was −3.1 and −3.5 at the TH and −2.6 and −2.9 at the FN, respectively. However, when the predicted and observed T-score values disagree outside the 95% limit of agreement, the predicted T-score values are lower than the measured T-score values, overestimating the measured values between −2.0 and −4.0 SD. The DF and PT cutoff value for aBMD of 0.60 g/cm2 was a moderate predictor of T-score values at the TH and FN, with considerable inaccuracies outside the clinically acceptable limits of agreement. As such, the direct measurement of knee aBMD in persons with SCI should be performed, whenever possible, prior to prescribing weight bearing upright activities, such as robotic exoskeletal-assisted walking.

Author(s):