Bone morphology of the femur and tibia captured by statistical shape modelling predicts rapid bone loss in acute spinal cord injury patients |
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| Institution: | 1. Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, UK;2. Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK;3. Scottish Centre for Innovation in Spinal Cord Injury, Queen Elizabeth National Spinal Injuries Unit, Southern General Hospital, Glasgow, UK;1. Medicine, Indiana University School of Medicine, IN, USA;2. Medical and Molecular Genetics, Indiana University School of Medicine, IN, USA;3. Wellcome Trust Center for Human Genetics, Oxford OX3 7BN, United Kingdom;4. Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universitat Autònoma de Barcelona, 08193-Bellaterra, Barcelona, Spain;5. Clinical Neuroscience, Center for Molecular Medicine, Neuroimmunolgy Unit, Karolinska Institutet, S171 76 Stockholm, Sweden;1. Institute for Biomechanics, ETH Zurich, Zurich, Switzerland;2. Composite Metal Technologies, Hampshire, United Kingdom;3. pfm medical titanium gmbh, Nuremberg, Germany;4. Department of Aerospace and Mechanical Engineering, University of Liege, Liege, Belgium;1. Department of Biomedical Engineering, Eindhoven University of Technology, High Tech Campus 11-p1.243, 5656 AE Eindhoven, The Netherlands;2. Philips Research Europe, High Tech Campus 11-p1.261A, 5656 AE Eindhoven, The Netherlands;3. Department of Pathology, University Medical Center Utrecht, Room H04.312, Utrecht, The Netherlands;1. Department of Orthopaedic Surgery, Washington University, Campus Box 8233, 660 South Euclid Avenue, St. Louis, MO 63110, USA;2. Department of Medicine, Washington University, St. Louis, MO, USA;3. Department of Developmental Biology, Washington University, St. Louis, MO, USA;4. Department of Biomedical Engineering, Washington University, St. Louis, MO, USA;1. Product Research Department, Fuji-Gotemba Research Laboratories, Chugai Pharmaceutical Co., Ltd., 1-135 Komakado, Gotemba, Shizuoka 412-8513 Japan;2. Pharmacology 3, Pharmacology Laboratories, Research Headquarters, Taisho Pharmaceutical Co., Ltd., 1-403 Yoshino-cho, Kita-ku, Saitama 331-9530 Japan;3. Discovery Pharmacology Dept. 1, Fuji-Gotemba Research Laboratories, Chugai Pharmaceutical Co., Ltd., 1-135 Komakado, Gotemba, Shizuoka 412-8513 Japan;4. Primary Lifecycle Management Dept., Chugai Pharmaceutical Co., Ltd., 2-1-1 Nihombashi Muromachi, Chuo-ku, Tokyo 103-8324, Japan;5. Roche Pharmaceutical Research and Early Development, Discovery Oncology, Roche Innovation Center Penzberg, Nonnenwald 2, D-82377 Penzberg, Germany;1. Botnar Research Centre, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Science, University of Oxford, Oxford OX3 7LD, UK;2. Structural Genomics Consortium, University of Oxford, Oxford OX3 7DQ, UK;3. Chemistry Department, University of Cincinnati, Cincinnati, OH 45221, USA;4. Department of Chemistry, University of Rochester, Rochester, NY 14627, USA;5. Mellanby Centre for Bone Research, University of Sheffield Medical School, Sheffield S10 2RX, UK;6. Monsanto, St Louis, MO, USA.;7. Shamrock Structures, Woodridge, Illinois, USA. |
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| Abstract: | After spinal cord injury (SCI), bone loss in the paralysed limbs progresses at variable rates. Decreases in bone mineral density (BMD) in the first year range from 1% (slow) to 40% (rapid). In chronic SCI, fragility fractures commonly occur around the knee, with significant associated morbidity. Osteoporosis treatments await full evaluation in SCI, but should be initiated early and targeted towards patients exhibiting rapid bone loss. The potential to predict rapid bone loss from a single bone scan within weeks of a SCI was investigated using statistical shape modelling (SSM) of bone morphology, hypothesis: baseline bone shape predicts bone loss at 12-months post-injury at fracture-prone sites.In this retrospective cohort study 25 SCI patients (median age, 33 years) were scanned at the distal femur and proximal tibia using peripheral Quantitative Computed Tomography at < 5 weeks (baseline), 4, 8 and 12 months post-injury. An SSM was made for each bone. Links between the baseline shape-modes and 12-month total and trabecular BMD loss were analysed using multiple linear regression.One mode from each SSM significantly predicted bone loss (age-adjusted P < 0.05 R2 = 0.37–0.61) at baseline. An elongated intercondylar femoral notch (femur mode 4, + 1 SD from the mean) was associated with 8.2% additional loss of femoral trabecular BMD at 12-months. A more concave posterior tibial fossa (tibia mode 3, + 1 SD) was associated with 9.4% additional 12-month tibial trabecular BMD loss.Baseline bone shape determined from a single bone scan is a valid imaging biomarker for the prediction of 12-month bone loss in SCI patients. |
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