Is Rapid Bone Loss Captured by Bone Shape in Spinal Cord Injury Patients?

Introduction: Spinal Cord Injury (SCI) can trigger bone loss below the level of injury. Bone loss and fractures most commonly occur at the distal femur and proximal tibia and are associated with significantly increased morbidity. Bone loss following SCI has been shown to vary between 0 and 40 % in the first year, with no current biomarkers to predict who will suffer severe bone loss. Standard osteoporosis treatments are risky for SCI patients and most effective in the early stages, therefore early identification of those at greatest risk is desirable. Active Shape Modelling (ASM) is a statistical technique for modelling bone morphology that predicts postmenopausal hip fractures. SCI can be considered an accelerated model of osteoporosis progression, and biomarkers for bone loss in SCI may be applicable to those at high risk of developing osteoporosis in the general population. This study investigated whether ASM predicts SCI-associated bone loss.