Abstract：
STUDY DESIGN:A cross-sectional study. OBJECTIVE:To clarify the existing controversy with regard to whether paraplegic patients suffer a loss of bone mass in the upper limbs. SETTING:Madrid, Spain. METHODS:We evaluated bone mass by phalangeal ultrasonography in 35 male patients with paraplegia (mean age 49+/-12 years), and 25(OH)D3 and PTH to exclude the presence of osteomalacia and secondary hyperparathyroidism. Spasticity was evaluated according to the Ashworth scale. Patients were compared with a control group of 35 healthy male subjects (mean age 48+/-13 years). RESULTS:The patients had lower 25(OH)D3 levels and amplitude-dependent speed of sound (Ad-SOS) than controls (both P<0.001), and higher PTH levels (P<0.05). There was a statistically significant negative association between PTH and 25(OH)D3 levels (r=-0.52, P<0.0001, CI -0.73 to -0.22) and between 25(OH)D3 and injury duration (r=0.34, P<0.05, CI -0.60 to -0.01). There was no correlation between Ad-SOS values, levels of PTH or 25(OH)D3, and the injury duration. No significant difference in Ad-SOS values was found in patients grouped according to low-to-normal 25(OH)D3 level or according to normal-to-high PTH level. There were no differences in relation to muscle tone. Only alkaline phosphatase and tartrate-resistant acid phosphatase levels were higher in patients than in controls (both P<0.001). CONCLUSION:Paraplegic patients had a loss of phalangeal bone mass that was unrelated to the levels of vitamin D or PTH, or to muscle tone, so it seems to be related to increased bone resorption rather than to deficient bone formation.
journal_name
Spinal Cordjournal_title
Spinal cordauthors
Pedrera JD,Mañas P,Gómez MA,Canal ML,Lavado JM,Hernández ER,Rico Hdoi
10.1038/sj.sc.3101256subject
Has Abstractpub_date
2002-02-01 00:00:00pages
83-7issue
2eissn
1362-4393issn
1476-5624journal_volume
40pub_type
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