The mechanical consequence of actual bone loss and simulated bone recovery in acute spinal cord injury.
The mechanical consequence of actual bone loss and simulated bone recovery in acute spinal cord injury.
复制标题
急性脊髓损伤中实际骨质流失和模拟骨恢复的机械后果。
DOI：
10.1016/j.bone.2013.12.012
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发表时间：
2014-03
期刊：
影响因子：
4.1
通讯作者：
Troy, Karen L.
中科院分区：
文献类型：
--
作者：
Edwards, W. Brent;Schnitzer, Thomas J.;Troy, Karen L.
脊髓损伤(SCI)的特征是迅速的骨丢失和增加膝关节周围区域脆性骨折的风险。我们的目的是量化急性脊髓损伤中由于实际骨丢失和模拟骨恢复而导致的胫骨近端扭转刚度K和强度Tult的变化。对10名急性脊髓损伤患者进行了计算机断层扫描，扫描时间间隔为平均3.9个月(3.0至4.8个月)。骨矿物质的减少被量化，并使用经过验证的受试者特定的有限元建模程序来预测K和TULT的变化。随后使用建模程序来检验模拟假想治疗的效果，在模拟假想治疗中，胫骨近端的骨矿物质恢复到基线水平，而所有其他参数保持不变。在脊髓损伤急性期，受试者的骨密度下降了8.3±4.9%(p<；0.001)。K值(−9.9±6.5%；p=0.002)的下降幅度与骨密度的下降幅度相似，而TULT(−15.8±13.8%；p=0.005)的下降幅度约为骨密度下降的2倍。由于几何形状和矿物质分布的结构变化，当骨矿物质恢复到基线时，TULT不一定恢复，但取决于假想治疗前骨丢失的程度(r≥0.719；p≤0.019)。应在损伤后立即进行治疗干预，以阻止或减轻与脊髓损伤相关的骨丢失，以试图保持机械完整性和防止骨折。
Spinal cord injury (SCI) is characterized by rapid bone loss and an increased risk of fragility fracture around regions of the knee. Our purpose was to quantify changes in torsional stiffness K and strength Tult at the proximal tibia due to actual bone loss and simulated bone recovery in acute SCI. Computed tomography scans were acquired on ten subjects with acute SCI at serial time points separated by a mean of 3.9 months (range 3.0 to 4.8 months). Reductions in bone mineral were quantified and a validated subject-specific finite element modeling procedure was used to predict changes in K and Tult. The modeling procedure was subsequently used to examine the effect of simulated hypothetical treatments, in which bone mineral of the proximal tibiae were restored to baseline levels, while all other parameters were held constant. During the acute period of SCI, subjects lost 8.3 ± 4.9% (p<0.001) of their bone mineral density (BMD). Reductions in K (−9.9 ± 6.5%; p=0.002) were similar in magnitude to reductions in BMD, however reductions in Tult (−15.8 ± 13.8%; p=0.005) were some 2 times greater than the reductions in BMD. Owing to structural changes in geometry and mineral distribution, Tult was not necessarily recovered when bone mineral was restored to baseline, but was dependent upon the degree of bone loss prior to hypothetical treatments (r≥0.719; p≤0.019). Therapeutic interventions to halt or attenuate bone loss associated with SCI should be implemented soon after injury in an attempt to preserve mechanical integrity and prevent fracture.
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影响因子：
2.4
作者：
Edwards WB;Schnitzer TJ;Troy KL
通讯作者：
Troy KL
影响因子：
4.1
作者：
Keyak, J. H.;Koyama, A. K.;Lang, T. F.
通讯作者：
Lang, T. F.
影响因子：
6.2
作者：
Marshall, Lynn M.;Lang, Thomas F.;Orwoll, Eric S.
通讯作者：
Orwoll, Eric S.
影响因子：
3
作者：
de Bruin, ED;Dietz, V;Stüssi, E
通讯作者：
Stüssi, E
影响因子：
2.8
作者：
GARLAND, DE;STEWART, CA;WEINSTEIN, DA
通讯作者：
WEINSTEIN, DA