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The weight bearing paraplegic arm
Abstracts / Bone 48 (2011) S236–S245
PP463-S Bone mineral density in patients with heterotopic ossification after spinal cord injury V. Povoroznyuk ⁎, M. Bystrytska Institute of Gerontology AMS Ukraine, Kyiv, Ukraine
Abstract: Aim: The aim of this research is to define the bone mineral density in patients with spine injury with and without heterotopic ossification. Methods: Clinical — determining the degree of spinal cord injury scale ASIA, dual-energy X-ray absorptiometry. The study included 21 patients with spinal cord injury, which were divided into two groups depending on the availability of heterotopic ossification. The first group included 10 patients with spinal cord injury with the presence of heterotopic ossification (average age 26.6 ±4.1 years, duration of traumatic spinal cord disease — 7.89 ± 2.74 months), the second group consisted 11 patients with traumatic disease spinal cord without heterotopic ossification, the average age of 29.4± 3.18 years, duration of traumatic spinal cord disease 8.67 ± 0.95 months. Results: BMD of the whole group on all locations was normal with total body Z-score (−0.56± 1,12), lumbar Z-score (−0.04± 1.03), trochanter Z-score (−0.42 ±3.4), and total hip Z-score (−0.03 ±2.8), but, when patients with large ossifications in hip were excluded, the BMD was reduced on the level of the proximal part of the hip, total hip Z-score (−1.29 ±0.96), and especially on the level of trochanter, trochanter Zscore (−1.94± 0.13). But, comparing two groups, significant difference of BMD in different skeletal parts was not observed. Total body (BMD Group I −1.14 ± 0.12 g/cm2, BMD Group II −1.15 ±0.06 g/cm2, T = 0.02, p = 0.97, lumbar BMD group I −1. 22 ±0.12 g/cm2, BMD Group II −1.15 ±0.16 g/cm2, T = 0.85, p = 0.42, and total hip BMD group I −1.21 ± 0.56 g/cm2, BMD Group II −0.90 ± 0.09 g/cm2, T = 1.3, p = 0.22. Conclusion: Spinal cord injury leads to the decrease of BMD on the level of the hip, in difference with idiopathic osteoporosis when the minimal BMD is registered on the level of WARDS triangle. But massive ossifications in the hip prevent us to obtain corrective results by means of summarization the density of the bone and ossification, thus, this does not allow us to observe the decrease in the real mineral density of the bone in this category of patients. This article is part of a Special Issue entitled ECTS 2011. Disclosure of interest: None declared.
doi:10.1016/j.bone.2011.03.594
S245
PP464-M The weight bearing paraplegic arm Y. Dionyssiotis a,b,⁎, G. Trovas b, K. Petropoulou c, G.P. Lyritis b, N. Papaioannou b a Rehabilitation Department, Rhodes General Hospital, Rhodes, Greece b Laboratory for Research of the Musculoskeletal System, University of Athens, Kifissia, Greece c 2nd Rehabilitation Department, National Rehabilitation Center, Athens, Greece Abstract: Objective: Subjects with spinal cord injury lose muscle and bone mass, but have increased body fat in areas below the level of neurological injury. On the other hand, paraplegia is associated with continued use of upper extremities. The purpose of this study was to investigate the changes in composition of paraplegics' upper limbs according to the neurological level of injury. Methods and Material: The study included paraplegics in chronic phase (>1.5 years) with complete paraplegia (AIS A) divided according to the neurological level of injury in group A (n = 16, high paraplegia: above thoracic (T) 7 neurological level of injury (NLoI) with mean age: 33 ± 16 years and duration of paralysis (DoP): 6 ± 6 years, and group B (n = 15, low paraplegia, T8-T12 NLoI with mean age: 39 ± 14 years and DoP: 5.6 ± 6 years compared with 33 healthy controls (group C) of similar anthropometric characteristics. All were examined by whole body DEXA (Norland XR 36, Norland Corp., USA) regarding the local (arms) bone density, muscle mass and fat mass. Results: Bone density was found statistically significant between groups (p = 0.008) and pair-wise comparisons revealed statistically significant differences between high vs. low paraplegic group and controls (p = 0.028, p = 0.01, respectively). A negative correlation was found in high paraplegic group of muscle to fat mass (p = 0.009, r = −0.67). Discussion: In this study investigation regarding the NLoI unmasked significant BMD lower values and a significant correlation in high paraplegics means that the NLOI determines the extent of alterations in body composition. This article is part of a Special Issue entitled ECTS 2011. Disclosure of interest: None declared.
doi:10.1016/j.bone.2011.03.680
PP463-S Bone mineral density in patients with heterotopic ossification after spinal cord injury V. Povoroznyuk ⁎, M. Bystrytska Institute of Gerontology AMS Ukraine, Kyiv, Ukraine
Abstract: Aim: The aim of this research is to define the bone mineral density in patients with spine injury with and without heterotopic ossification. Methods: Clinical — determining the degree of spinal cord injury scale ASIA, dual-energy X-ray absorptiometry. The study included 21 patients with spinal cord injury, which were divided into two groups depending on the availability of heterotopic ossification. The first group included 10 patients with spinal cord injury with the presence of heterotopic ossification (average age 26.6 ±4.1 years, duration of traumatic spinal cord disease — 7.89 ± 2.74 months), the second group consisted 11 patients with traumatic disease spinal cord without heterotopic ossification, the average age of 29.4± 3.18 years, duration of traumatic spinal cord disease 8.67 ± 0.95 months. Results: BMD of the whole group on all locations was normal with total body Z-score (−0.56± 1,12), lumbar Z-score (−0.04± 1.03), trochanter Z-score (−0.42 ±3.4), and total hip Z-score (−0.03 ±2.8), but, when patients with large ossifications in hip were excluded, the BMD was reduced on the level of the proximal part of the hip, total hip Z-score (−1.29 ±0.96), and especially on the level of trochanter, trochanter Zscore (−1.94± 0.13). But, comparing two groups, significant difference of BMD in different skeletal parts was not observed. Total body (BMD Group I −1.14 ± 0.12 g/cm2, BMD Group II −1.15 ±0.06 g/cm2, T = 0.02, p = 0.97, lumbar BMD group I −1. 22 ±0.12 g/cm2, BMD Group II −1.15 ±0.16 g/cm2, T = 0.85, p = 0.42, and total hip BMD group I −1.21 ± 0.56 g/cm2, BMD Group II −0.90 ± 0.09 g/cm2, T = 1.3, p = 0.22. Conclusion: Spinal cord injury leads to the decrease of BMD on the level of the hip, in difference with idiopathic osteoporosis when the minimal BMD is registered on the level of WARDS triangle. But massive ossifications in the hip prevent us to obtain corrective results by means of summarization the density of the bone and ossification, thus, this does not allow us to observe the decrease in the real mineral density of the bone in this category of patients. This article is part of a Special Issue entitled ECTS 2011. Disclosure of interest: None declared.
doi:10.1016/j.bone.2011.03.594
S245
PP464-M The weight bearing paraplegic arm Y. Dionyssiotis a,b,⁎, G. Trovas b, K. Petropoulou c, G.P. Lyritis b, N. Papaioannou b a Rehabilitation Department, Rhodes General Hospital, Rhodes, Greece b Laboratory for Research of the Musculoskeletal System, University of Athens, Kifissia, Greece c 2nd Rehabilitation Department, National Rehabilitation Center, Athens, Greece Abstract: Objective: Subjects with spinal cord injury lose muscle and bone mass, but have increased body fat in areas below the level of neurological injury. On the other hand, paraplegia is associated with continued use of upper extremities. The purpose of this study was to investigate the changes in composition of paraplegics' upper limbs according to the neurological level of injury. Methods and Material: The study included paraplegics in chronic phase (>1.5 years) with complete paraplegia (AIS A) divided according to the neurological level of injury in group A (n = 16, high paraplegia: above thoracic (T) 7 neurological level of injury (NLoI) with mean age: 33 ± 16 years and duration of paralysis (DoP): 6 ± 6 years, and group B (n = 15, low paraplegia, T8-T12 NLoI with mean age: 39 ± 14 years and DoP: 5.6 ± 6 years compared with 33 healthy controls (group C) of similar anthropometric characteristics. All were examined by whole body DEXA (Norland XR 36, Norland Corp., USA) regarding the local (arms) bone density, muscle mass and fat mass. Results: Bone density was found statistically significant between groups (p = 0.008) and pair-wise comparisons revealed statistically significant differences between high vs. low paraplegic group and controls (p = 0.028, p = 0.01, respectively). A negative correlation was found in high paraplegic group of muscle to fat mass (p = 0.009, r = −0.67). Discussion: In this study investigation regarding the NLoI unmasked significant BMD lower values and a significant correlation in high paraplegics means that the NLOI determines the extent of alterations in body composition. This article is part of a Special Issue entitled ECTS 2011. Disclosure of interest: None declared.
doi:10.1016/j.bone.2011.03.680