Abstract
The osteoporosis which appears in paraplegics below the neurological lesion has been studied in 100 patients with the following parameters: quantitative X-rays, urinary hydroxyproline excretion, kinetic study of calcium metabolism by 45Ca, serum phosphorus and calcium, parathormone and calcitonin radio-immunoassay, quantitative histology, density fractionation of bone and amino-acid composition of fractionated bone analysis.
All our results show that the important bone resorption occurring very early in the paraplegia is immediately followed by an increase of the bone repair. This osteoporosis below the neurological lesion in paraplegia represents an unbalance between the synthesis and the resorption of bone which possesses a large degree of activity. Furthermore, we demonstrated that the collagen of this bone is underhydroxylated. Following the quantitative X-rays and intraosseous phlebography results we have considered the aetiopathogenesis of this osteoporosis. It seems that vascular modifications due to the lesion of the autonomic nervous system play an important role and furthermore we believe that immobilisation represents only a minor factor in the aetiology of this osteoporosis.
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Andrew, C & Basset, L (1971). Biophysical Principles affecting Bone Structure: Volume 3. Academic Press, New York, p. 584.
Benassy, J, Mazabraud, J & Diverres, J C (1963). L'ostéogénèse neurogène. Rev. Chir. Orthop., 49, 95–116.
Chantraine, A (1971). Clinical investigations of bone metabolism in spinal cord lesions. Paraplegia, 8, 253–259.
Chantraine, A, Chapard, R & Leroux, G (1976a). Étude radiologique de la masse osseuse chez le paraplégique. Comptes rendus du 1er Symposium CEMO. Méd. et Hyg. Genevè, 44–52.
Chantraine, A, Nusgens, B & Lapiere, Ch M (1976b). Underhydroxylated collagen in bone of patients with spinal cord lesion. Vme meeting, European Fed. of the Connective Tissue Clubs, Liège, 31–32.
Chantraine, A, Hacher, H J & Schinas, P (1978). Étude de la pression intra-médullaire de l'os chez le paraplégique. Premiers enseignements To be published.
Chantraine, A, Meunier, P, Minaire, P, Edouard, C, Bernard, J & Delvigne, M A (1974). Étude histologique quantitative de l'os du paraplégique. J. Belge Rhum. Méd. Phys. 29, 174–195.
Dequeker, J (1972). Bone Loss in Normal and Pathological Conditions. Leuven Univ. Press, pp. 1–214.
Dhem, A (1973). Les mécanismes de destruction du tissu osseux. Acta Orthop. Belg. 39, 423–433.
Franchimont, P & Heynen, G (1976). Parathormone and Calcitonin Radioimmunoassay in Various Medical and Osteoarticular Disorders. Masson. Inc., pp. 1–131.
Galibert, P (1959). Remarques à propos du syndrome neuro-végétatif des traumatismes de la moelle épinière. Neurochir. 5, 355–359.
Heaney, R P (1962). Radiocalcium metabolism in disuse osteoporosis in man. Amer. J. Med. 33, 188–200.
Heynen, G, Chantraine, A & Franchimont, P (1978). Metabolic study in spinal cord injuries. To be published.
Malan, E & Puglionisi, A (1964). Congenital angiodysplasias of the extremities (note I: generalities and classification venous dysplasias). J. Cardiovasc. Surg. 5, 87–130.
Minaire, P, Meunier, P, Edouard, C, Bernard, J, Courpron, P & Bourret, J (1974). Quantitative histological data on disuse osteoporosis. Calcif. Tissue Res. 17, 57–73.
Nusgens, B, Chantraine, A & Lapiere, Ch M (1972). The protein in the matrix of bone. Clin. Orthop. and Related Research, 88, 251–274.
Rasmussen, H & Bordier, Ph (1973). The cellular basis of metabolic bone disease. New England J. Med. 289, 25–32.
Richelle, L J (1967). Contribution à l'étude du métabolisme minéral de l'os chez le rat. Thèse, Univ. Liège, 161.
Rosenbloom, J, Harsch, M & Jimenez, S (1973). Hydroxyproline content determines the denaturation temperature of chick tendon collagen. Arch. Biochem. Biophys. 156, 478.
Rossier, A B et al. (1973). Current facts on para-osteo-arthropathy (POA). Paraplegia, 11, 36–78.
Trueta, J (1964). The dynamics of bone circulation. In Bone Dynamics, ed. H. M. Frost. Little, Brown and Co, Boston, pp. 245–258.
Trueta, J (1968). Studies of the Development and Decay of the Human Frame. Heinemann, London.
Virtama, P & Helela, T (1969). Radiographic measurements of cortical bone: variations in a normal population between 1 and 90 years of age. Acta Radiolog., Suppl., 293.
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Chantraine, A. Actual concept of osteoporosis in paraplegia. Spinal Cord 16, 51–58 (1978). https://doi.org/10.1038/sc.1978.8
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DOI: https://doi.org/10.1038/sc.1978.8
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