Score Of Lumbar Spine Research Articles

Preoperative application of CT and MRI registration in lumbar disc herniation endoscopic surgery could improve the postoperative rehabilitation of patients.

Percutaneous Endoscopic Lumbar Discectomy (PELD) has emerged as routine treatment for lumbar disc herniation (LDH) due to its minimal invasiveness and quick recovery. However, PELD demands high precision from the surgeon, as the risk of intraoperative complications is substantial, including potential damage to the nerve root and dura, and a higher likelihood of recurrence post-surgery. Thus, preoperative planning utilizing CT and MRI imaging is essential. In this study, the clinical data of 140 patients treated with PELD for LDH from January 2021 to December 2023 were retrospectively analyzed. Patients were categorized into two groups based on whether CT and MRI registration (CMR) was employed for surgical planning: a CMR group (n=68) and a control group (n=72). Data collected included surgery time, hospital stay duration, and scores from the Visual Analog Scale (VAS) for low back and leg pain, as well as the Japanese Orthopaedic Association Lumbar Spine Score (JOA). Differences between the two groups were assessed using the Student's t-test. No significant difference was found in hospital stay length between the groups (P=0.277). Surgery time was significantly shorter in the CMR group (P<0.001). Prior to surgery, no significant differences in VAS scores for leg and low back pain were observed between the groups (P=0.341 and P=0.131, respectively); however, at 2 months postoperatively, both scores were significantly lower in the CMR group (P<0.001 and P=0.002, respectively). Similarly, no difference in preoperative JOA scores was noted (P=0.750), but at 2 months postoperative, the CMR group exhibited significantly higher scores (P<0.001). Compared with the traditional PELD, the preoperative use of CMR has shown to reduce surgery time, alleviate leg and low back pain, and increase the lumbar JOA score at 2 months after surgery, underscoring its efficacy in enhancing surgical outcomes.

Gut microbiota and plasma metabolites associated with bone mineral density in women with or at risk of HIV infection.

To evaluate gut microbiota (GMB) alterations and metabolite profile perturbations associated with bone mineral density (BMD) in the context of HIV infection. Cross-sectional studies of 58 women with chronic HIV infection receiving antiretroviral therapy and 33 women without HIV infection. We examined associations of GMB and metabolites with BMD among 91 women. BMD was measured by dual-energy X-ray absorptiometry (DXA), and T -scores of lumbar spine or total hip less than -1 defined low BMD. GMB was measured by 16S rRNA V4 region sequencing on fecal samples, and plasma metabolites were measured by liquid chromatography-tandem mass spectrometry. Associations of GMB with plasma metabolites were assessed in a larger sample (418 women; 280 HIV+ and 138 HIV-). Relative abundances of five predominant bacterial genera ( Dorea , Megasphaera , unclassified Lachnospiraceae, Ruminococcus , and Mitsuokella ) were higher in women with low BMD compared with those with normal BMD (all linear discriminant analysis (LDA) scores >2.0). A distinct plasma metabolite profile was identified in women with low BMD, featuring lower levels of several metabolites belonging to amino acids, carnitines, caffeine, fatty acids, pyridines, and retinoids, compared with those with normal BMD. BMD-associated bacterial genera, especially Megasphaera , were inversely associated with several BMD-related metabolites (e.g. 4-pyridoxic acid, C4 carnitine, creatinine, and dimethylglycine). The inverse association of Megasphaera with dimethylglycine was more pronounced in women with HIV infection compared with those without HIV infection ( P for interaction = 0.016). Among women with and at risk of HIV infection, we identified altered GMB and plasma metabolite profiles associated with low BMD.

Plasma Biomarkers for Clinical Assessment of Bone Mineral Density in Heart Transplanted Patients-A Single-Center Study at Skåne University Hospital in Lund.

We aimed to identify plasma biomarkers that predict changes in bone mineral density (BMD) and increase the understanding of impaired BMD after heart transplantation (HT). Twenty-eight adult patients were included. Data, including densitometry and 29 plasma proteins, before and 1 year after HT were analyzed. Pre-HT plasma levels of fibroblast growth factor 23 (FGF23) correlated with post-HT T score in lumbar spine, adjusted for age, gender, and BMI (1.72 [95% CI 1.33; 2.22], p = 0.011). Change (∆; post-HT—pre-HT) in plasma levels of melusin correlated to ∆T score from the lumbar spine (p = 0.028). ∆plasma levels of TR-AP, ITGB2, and Stromelysin-1 correlated to ∆T score from the femoral neck (p < 0.05). However, no correlations remained after adjustments for age, gender, and BMI. In conclusion, elevated plasma FGF23 pre-HT predicted an increase in lumbar BMD after HT. However, the results are surprising since FGF23 is known to be inversely correlated with BMD. This may partly be explained by the complex pathophysiology in this particular cohort. Due to the explorative nature of the study and the small sample size, further investigations of biochemical markers on bone metabolism in this patient population are encouraged.

Hydroxyapatite/collagen composite graft for posterior lumbar interbody fusion: a comparison with local bone graft

BackgroundAutologous bone has been used for posterior lumbar intervertebral fusion (PLIF). However, harvesting autologous bone graft is associated with donor site complications. We previously developed a hydroxyapatite/collagen (HAp/Col) composite as an osteoconductive artificial bone, characterized by having a highly porous structure with sponge‐like elasticity. This study aims to investigate the effectiveness of HAp/Col composite with bone marrow aspirate (BMA) as a graft substitute in PLIF for the treatment of lumbar spinal diseases.MethodsThis study prospectively investigated patients who received one-level PLIF. For the interbody fusion, two titanium cages were inserted. On the one side of interbody space, HAp/Col composite incorporated with BMA filling the titanium cage was grafted. On the other side, local bone graft (LBG) harvested during decompressive laminotomy was grafted and then one-level instrumentation using pedicle screws was performed. The target levels were at L2/3 in 2 cases, L3/4 in 3 cases, L4/5 in 36 cases, and L5/S in 5 cases. We evaluated clinical symptoms and radiological outcomes of 46 patients and compared the fusion status of HAp/Col composite with that of LBG.ResultsThe 1-year postoperative CT evaluation demonstrated that, in the HAp/Col, a complete fusion was observed in 38 patients (82.6%), whereas in the LBG, a complete fusion was observed in 35 patients (76.1%). There were no statistical differences between the HAp/Col and LBG. In the HAp/Col, incomplete fusion was observed in five patients (10.9%) and non-fusion in two patients (4.3%), and in the LBG, incomplete fusion was observed in nine patients (19.6%) and non-fusion in two patients (4.3%). At 2 years after the surgery, complete fusion increased to 44 patients (95.7%) in the HAp/Col and 41 patients (89.1%) in the LBG. There were no significant differences in the clinical scores for lumbar spine between patients with fusion and non-fusion.ConclusionsThe HAp/Col composite with BMA in the titanium cage can be effectively used as an alternative to conventional autologous LBG for intervertebral spinal fusion.Trial registration University hospital Medical Information Network, UMIN000045010, July 30th, 2021, Retrospectively registered, https://www.umin.ac.jp/english/.

Bone mineral density and nourishment

Some diet pattern is connected with higher risk of obesity and deficit of different nutrients. Both can contribute to complications of chronic disease like osteoporosis. The primary objective of this study was to analyze the correlation between bone mineral density and body mass, i.e. nutrients intake. The cross-sectional study included 25 patients who had regular osteodensitometrycal checkup. Patients anthropometrics' characteristics were collected by interview. Dietary pattern was estimated through food-frequency questionnaire and average meal was made. Nutritional analysis computer program (Nutrics Professional Nutrition Analysis Software) was used to analyze the average intake of nutrients from the food intake data. The average T score of hip was at level of osteopenia (-1.7), and BMI was 25.80 kg/m2. By comparing the results using Pearson coefficient, we found positive linear trend and statistical significance at p &lt;0.05. The average T score of lumbar spine was at level of osteoporosis (-2,19), and average intake of calcium was 1519 mg. By comparing the results using Pearson coefficient, we found negative linear trend and statistical significance at p &lt;0.05. These data indicate that BMI and nutrients intake are connected with the risk for osteoporosis. There is the need for osteoporosis prevention strategies based on nutrition recommendations.

Early effectiveness of oblique lateral interbody fusion combined with pedicle screw fixation via small incision Wiltse approach for lumbar spondylolisthesis

To investigate the early effctiveness of oblique lateral interbody fusion (OLIF) combined with pedicle screw fixation via small incision Wiltse approach for the treatment of lumbar spondylolisthesis. Between January 2016 and December 2016, 21 patients with lumbar spondylolisthesis were treated with OLIF and pedicle screw fixation via small incision Wiltse approach. There were 9 males and 12 females, aged 57-73 years, with an average age of 64.5 years. The disease duration was 24-60 months, with an average of 34.6 months. All cases were spondylolisthesis at L 4 (15 cases of degreeⅠ, 6 cases of degreeⅡ); 1 case had vertebral arch isthmus, and 20 cases had spinal stenosis. Japanese Orthopaedic Association (JOA) scoring system was used to evaluate the effectiveness before operation and at last follow-up. Before operation and at 2 days after operation, anteroposterior and lateral X-ray films and CT were taken to measure the sagittal diameter and cross-sectional area of the spinal canal, and calculate the intervertebral height and degree of spondylolisthesis. At 6 months after operation, the intervertebral fusion was evaluated by CT. The operation time was 120-180 minutes, with an average of 155 minutes; the intraoperative blood loss was 100-340 mL, with an average of 225.5 mL. One patient had slight injury of lower endplate, 1 patient had numbness of thigh and weakness of hip flexion after operation, 1 patient had sympathetic nerve trunk injury. All the cases were followed up 12-18 months, with an average of 14.3 months. The symptoms of low back pain, leg pain, and numbness of lower limbs significantly relieved after operation, and there was no complication such as protrusion of fusion cage, screw breakage, and endplate collapse. At 2 days after operation, the intervertebral height, degree of spondylolisthesis, sagittal diameter of spinal canal, and cross-sectional area of spinal canal significantly improved compared with preoperative ones ( P<0.05). At 6 months after operation, CT showed that 1 patient had poor interbody fusion (grade Ⅲ), the other 20 patients had good interbody fusion (grade Ⅰ and Ⅱ), and the interbody fusion rate was 95.2%. At last follow-up, JOA score of lumbar spine significantly increased compared with that before operation ( t=24.980, P=0.000). OLIF combined with pedicle screw fixation via small incision Wiltse approach for the lumbar spondylolisthesis has minimally invasive features, such as less trauma, fewer complications, and higher intervertebral fusion rate. It is a safe and effective method.

Gaucher disease status and treatment assessment: pilot study using magnetic resonance spectroscopy bone marrow fat fractions in pediatric patients

ObjectiveTo assess magnetic resonance spectroscopy (MRS) bone marrow fat fractions' ability to discern between untreated Gaucher disease patients and healthy controls based on assessment of bone marrow infiltration and evaluate response to enzyme replacement therapy (ERT) on serial imaging. MethodsThis retrospective case-controlled study compared conventional MRI and bone marrow MRS findings in six pediatric and young adult Gaucher disease patients with age- and sex-matched controls, examining femoral neck and lumbar spine bone marrow fat fractions and bone marrow burden (BMB) scores. Separate analysis of six patients with serial imaging on ERT was performed with analysis of fat fractions, BMB scores, organ volumes, and serum chitotriosidase. ResultsUntreated patients had significantly lower femoral and lumbar spine fat fractions than controls (0.32 versus 0.67, p = 0.041 and 0.17 versus 0.34, p = 0.041, respectively). Total BMB scores were significantly higher in patients (8.0 versus 3.5, p = 0.015). In patients on ERT with average follow-up of 3.5 years, femoral neck fat fraction was the sole significant predictor of treatment duration (R square: 0.804, p < 0.001) when adjusted for age. Femoral neck fat fraction also correlated with lumbar spine fat fraction, liver volume and chitotriosidase (p < 0.05). MRS test-retest reliability was excellent (Pearson correlations: 0.96, 0.99; p-values <0.001). BMB inter-rater reliability was good overall with an intra-class correlation coefficient of 0.79 for total score, although lumbar spine score reliability was poor at 0.45. ConclusionMRS-derived bone marrow fat fractions appear capable of detecting Gaucher disease severity and monitoring treatment-related changes as a predictor of ERT duration in pediatric and young adult patients.

Bone Mineral Density Distribution Curves in Spanish Adults With Down Syndrome

According to reports from small-sized case series, adults with Down syndrome (DS) appear to have lower bone mineral density (BMD) than the general population. The objective of our study was to further characterize the bone mass acquisition curve in an adult DS population. This is a retrospective study of 297 adults with DS from the Adult Down Syndrome Outpatient Clinic of a tertiary care hospital in Madrid, Spain, who underwent a bone densitometry (Hologic QDR-4500W), for clinical purposes between January 2010 and June 2015. The mean age of our sample population was 34 yr (±10.9); 51% were women. Bone mass peak was reached earlier and was lower than the general population (around 20–25 yr), with almost parallel curves. The mean BMD was 0.715 ± 0.12 g/cm2 in femoral neck (FN) and 0.872 ± 0.11 g/cm2 in lumbar spine (LS). According to FN scores, 52% of the subjects were classified as osteopenic and 18% as osteoporotic. According to LS scores, frequencies were 54% and 25%, respectively. BMD was considered inadequate for the age (Z-score < −2 standard deviation) in 18% of the subjects at FN and 40% at LS. BMD at LS was significantly lower in males than in females (52% vs 38%, p < 0.001). Male DS subjects had a 2.58-fold (95% confidence interval: 1.57–4.25) higher risk of developing reduced BMD at LS than females. Persons with DS reach the bone mass peak earlier and this bone mass is lower than the general population. Among subjects with DS, male gender is a risk factor for developing low BMD, especially at LS.

Pegylated interferon α/ribavirin therapy enhances bone mineral density in children with chronic genotype 4 HCV infection.

The impact of chronic hepatitis C (CHC) on bone mineral density (BMD) has been well studied in adults with a relative paucity of data in children, especially concerning effect of treatment with pegylated interferon (PEG-IFN) plus ribavirin (RV). In the current work, we assessed prospectively changes in BMD in children with CHC before, during, and after treatment. Forty-six consecutive children with noncirrhotic genotype 4 CHC were subjected to dual-energy X-ray absorptiometry at baseline, 24 weeks, 48 weeks of therapy and 24 weeks after treatment. BMD, bone mineral content (BMC), and Z score of lumbar spine (L2-L4) were reported. Tanner pubertal stage, viral load, liver function tests, serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone, and liver histopathology were assessed in all included children. Thirty (65.2%) patients had normal BMD, 10 (21.7%) were at risk for low BMD, and 6 (13.1%) had low BMD for chronological age. Patients with low BMD were significantly older (P=0.001), with higher frequency of delayed puberty than other groups (P=0.002). Baseline densitometric parameters (BMD & BMC) were significantly positively correlated with patients' age, weight, height, body mass index and hemoglobin level; while they were insignificantly correlated with basal viral load, histopathology activity index and fibrosis score. Densitometric parameters improved significantly on PEG-IFN plus RV treatment, this improvement was found to be sustainable 24 weeks after therapy. Low BMD is detectable in a proportion of CHC children. Antiviral therapy leads to a sustainable increase in BMD.

The Association of Omentin Levels in Non-Diabetic Postmenopausal Women with Bone Mineral Density and Total Body Composition

Objectives: Positive relation between body mass and bone mineral density (BMD) is thought to be due to weight bearing effect. However, adipose tissue derived adipokines may have important effects on bone. Obese women have decreased levels of omentin in circulation which is related with adverse metabolic events. The hypothesis was that performed in this study, we aimed to study the association of omentin levels with body composition and BMD in non-diabetic postmenopausal women. Methods: Postmenopausal women aged 40 to 70 years, scheduled for BMD testing were prospectively evaluated. Patients with known diabetes, chronic renal failure, chronic liver disease, malabsorption, inflammatory bowel disease, 70 years of age were excluded. BMD and body composition were measured by DXA (GE-Lunar DPX pro). Fasting blood samples were obtained for analysis of complete blood count, glucose, creatinine, lipid profile and omentin. Statistical analyses were performed by using SPSS version 18 for windows. P<0.05 was considered statistically significant. Results: Mean age of the patients in the osteoporosis group was higher than that of the control group (59.1±7.6 vs 53.3±5.7, p<0.05). Mean omentin level was higher in osteoporosis group than in osteopenia and control groups (479.7±141.6 vs 342.3±173.6 and 346.8±127.2, p<0.05). Total body fat mass, muscle mass and the T score of lumbar spine had a negative correlation with omentin levels (r=-0.252, -0.276, -0.344, p<0.05). Conclusions: Body composition does not seem to effect omentin levels. Women with a lower BMI have increased omentin levels. Higher omentin levels are associated with lower T scores at the lumbar spine.

Microsurgical Unilateral Approach Bilateral Decompression in Symptomatic Lumbar Spinal Canal Stenosis: Midterm Results in 89 Patients

Introduction Surgical decompression is the gold standard in the treatment of symptomatic lumbar spinal canal stenosis (LSCS) without clinically significant instability. With the advent of microsurgical techniques and better accessories such as the tubular retractor system (TRS), unilateral approach bilateral decompression (UABD) has been advocated as the decompressive technique of choice because of the preservation of anatomically important stabilizing structures. This retrospective study evaluates the midterm results of UABD performed with and without the TRS in a regional hospital. Patients and Methods From April 2008 till November 2013, 89 patients with symptomatic LSCS without clinical instability had UABD performed. On the basis of the surgeons' preference, 56 cases were operated with the TRS employed. The mean follow-up was 30.8 months. Clinical outcomes were evaluated by the Visual Analogue Scale (VAS), Japanese Orthopaedic Association lumbar spine score (JOA score), Oswestry Disability Index (ODI), and Roland Morris Disability Quotient (RMDQ). Complications, rate of reoperation, and patient's subjective satisfaction were also evaluated. Results A total of 150 levels were decompressed (average, 1.7 levels per patient). The average operation time and blood loss per level was 99.4 minutes and 67.9 mL, respectively. The mean postoperative hospital stay was 4.5 days. The average leg VAS, JOA score, ODI, and RMDQ improved from 7.1, 15.5, 48.3% and 13.1 to 3.3, 22.1, 35.4% and 11.5, respectively, at final follow-up. The subjective satisfaction was 64%. Given the choice, 92% of these patients would choose to have the same procedure again. There were no statistical significant difference between the TRS and no TRS group in age; sex; side of approach; the preoperative, postoperative, and improvement in leg VAS, JOA score, ODI, and RMDQ; follow-up duration; operation time; and subjective satisfaction. Blood loss (67 vs. 178.4 mL, p = 0.09) and postoperation hospital stay (3.9 vs. 5.7 days, p = 0.003) were both in favor of the TRS. Overall, five incidental durotomies in the TRS group (8.9%) and 3 (9%) in non-TRS group were registered, giving rise to a total 9% of the incidental durotomy rate. All of these eight cases were treated conservatively and none of them needed any further procedures as a remedy. Otherwise, no remarkable perioperative morbidities had been recorded. Within the evaluation period, two cases from the TRS group need re-decompression with instrumented fusion because of symptomatic recurrence, equivalent to an overall 2.2% reoperation rate. Conclusion Microsurgical UABD generates satisfactory clinical outcomes in selected patients with symptomatic LSCS without clinical instability. No apparent clinical benefit was found in employing the TRS other than an average 1.8 day short postoperative hospital stay.

Correlation Between Distal Radial Cortical Thickness and Bone Mineral Density

To determine interobserver reliability in measuring the cortical thickness of distal radiuses on posteroanterior radiographs obtained at the time of injury and to determine whether there is a correlation between distal radius cortical thickness and hip and lumbar spine scores on dual-energy x-ray absorptiometry (DXA). Four orthopedic surgeons at 2 academic institutions who were blinded to the study protocol reviewed standard posteroanterior wrist radiographs of 80 women over age 50 years with distal radius fractures with DXA data obtained within the past 2 years. Radial bicortical widths were measured at 50 and 70 mm proximal to the distal ulnar articular surface, and mean bicortical thickness was calculated from radiographs of the injured wrist. Average bicortical width was compared with each patient's femoral and lumbar spine bone density measures. Data were analyzed using Pearson correlation coefficients and simple linear regression. Inter-rater reliability was evaluated using intra-class correlation coefficients. The inter-rater reliability for average bicortical thickness had a high intra-class correlation coefficient value of 0.91. Average bicortical thickness showed a statistically significant positive relationship with femoral bone density. Average bicortical thickness was statistically correlated with femoral bone density values, with a 1-mm increase in average bicortical thickness associated with a 0.05 g/cm(2)-increase in femoral density. Average bicortical thickness was not associated with lumbar bone density. Bicortical thickness of the distal radius was positively correlated with femoral bone density but not with lumbar spine density. This may reflect similarity in quality and loading properties of the femur and radius as appendicular bones, compared with the axial spine. Identification of thinned distal radial cortices in association with distal radius fracture is a simple qualitative observation that should prompt further evaluation with DXA and medical management of bone insufficiency. Diagnostic II.

Osteoporosis in Systemic Lupus Erythematosus - Correlations with Disease Activity and Organ Damage.

Purpose: to assess the incidence of osteoporosis in a cohort of SLE patients and to determine the possible correlations with disease activity, organ damage and glucocorticoid therapy. Material and methods: We analyzed a cohort that included 25 consecutive SLE patients, diagnosed according to ACR revised criteria, and 21 controls, with the same demographic characteristics. We assessed demographic, life style related, clinical, biologic and immunologic data; also, we registered information about the treatment and calculated disease activity and damage scores. Bone mineral density was measured both in lumbar spine and total hip, using dual-energy X-ray absorptiometry. Results: Evaluation of T score profile, both in lumbar spine and total hip, established a percentage of 36 (9) patients with osteoporosis, 40 (10) patients with osteopenia and 24 (6) cases with normal values. Mean T score in lumbar spine was -1.28+1.31 SD and for the total hip -1.21+1.34 SD. Analysis of correlation between T score, both in lumbar spine and total hip, and SLEDAI, established a moderate, negative correlation; for SDI we obtained a moderate correlation, both for lumbar spine and total hip, statistically significant. Conclusions: our results show an increased percentage of osteoporosis among SLE patients and a relation to disease and treatment variables, imposing a periodic evaluation, in order to establish an early diagnosis, the proper therapeutic measures, and to prevent the major consequence, vertebral and non-vertebral fractures.

Predictive factors of radiographic progression in ankylosing spondylitis.

Background/AimsThe course of ankylosing spondylitis (AS) is rather variable, and the factors that predict radiographic progression remain largely obscure. In this study, we tried to determine the clinical factors and laboratory measures that are useful in predicting the radiographic progression of patients with AS.MethodsIn 64 consecutive patients with AS, we collected radiographic and laboratory data over 3 years. Radiographic data included images of the sacroiliac (SI) and hip joints and laboratory data included areas under the curve (AUC) of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), alkaline phosphatase (ALP), and hemoglobin (Hb). We investigated associations among changes in radiographic scores, initial clinical manifestations and laboratory measurements.ResultsChanges in scores for the SI joint and lumbar spine did not correlate with AUC for ESR, CRP, or ALP. AUC for Hb did not significantly correlate with radiographic progression in any joint. Patients with hip arthritis at the initial visit showed significantly higher radiographic score changes after 3 years in the SI and hip joint compared to those without hip arthritis. Patients who had shoulder arthritis as the initial manifestation had significantly increased AUCs for ESR and CRP compared to those without shoulder arthritis. However, at 3 years, the change of the lumbar spine score was significantly higher in patients without shoulder arthritis.ConclusionsThese results indicate that hip arthritis at presentation is a useful clinical marker for predicting the structural damage to the SI and hip joint, and suggest that initial shoulder arthritis correlates with slower radiographic progression of the lumbar spine.

AB0812 Spine-Hip Diagnostic Discordance among Osteoporotic Patients

BackgroundDiagnostic discordance for osteoporosis is the presence of different T-scores in two skeletal sites in the same subject leading to different WHO diagnostic categories. Discordance is defined as minor when...

Effect of Nicotine on RANKL and OPG and Bone Mineral Density

ABSTRACTAim: The signaling pathway OPG/RANK/RANKL is a key in maintaining the balance between the activity of osteoblasts and osteoclasts in order to prevent bone loss. In this study, our aim was to assess the effects of long-term nicotine exposure on plasma RANKL and OPG levels, tissue RANKL and OPG immunoreactivities, and bone mineral density (BMD) scores in rats. Materials and Methods: Thirty-six Swiss Albino rats weighing 70 ± 10 g were divided into three groups. While the controls (n = 12) were only given normal drinking water, for low-dose nicotine (LDN) group (n = 12) 0.4 mg/kg/day; for high-dose nicotine (HDN) group (n = 12), 6.0 mg/kg/day nicotine was added to drinking water for a year. At the end of 12th month, BMD scores were measured using an X-ray absorptiometry and bone turnover was assessed by measuring plasma RANKL and OPG levels and RANKL and OPG immunoreactivities in tail vertebrae of the rats. Results: There was no statistically significant difference in BMD scores of lumbar spine and femoral regions of the nicotine groups in comparison to controls. Plasma OPG levels were found to be significantly higher in HDN group, in comparison to the controls and LDN groups (p = .001) unlike plasma RANKL levels. Tissue RANKL and OPG immunoreactivities decreased significantly in the LDN and HDN groups (p < .001, p < .01, respectively). Conclusions: The results of this study show that nicotine is not primarily responsible for the decrease in BMD frequently seen in smokers. Measuring plasma RANKL and OPG levels did not reflect tissue immunoreactivities.

THE SPORT HABIT DURING YOUNGER AGE MAY BRING GOOD EFFECT FOR LOCOMOTORY SYSTEM AND FUNCTION. —FROM PERIODIC MEDICAL CHECKUP ON FORMER JAPANESE OLYMPIAN AT 1964—

BackgroundIn Japan, which is always the top-ranked life expectancy in the world, the healthcare issues for elderly people transitions from internal; cancer, cardiovascular and cerebrovascular disease to motor system and...

Bone Mineral Density in Moroccan Patients with Juvenile Idiopathic Arthritis

Aim: The aim of this study was to evaluate the bone mineral density (BMD) in Moroccan patients with juvenile idiopathic arthritis and its correlates with disease parameters and vitamin D status. Methods: Forty patients with juvenile idiopathic arthritis (JIA) were included in a cross-sectional study. The diagnosis of JIA was made according to the criteria of the International League of Association of Rheumatology (ILAR). Information on disease activity, quality of life, sex, age, age at diagnosis, duration of medication use and bone fractures were collected by use of a standardized questionnaire. Patients underwent anthropometric assessment, puberty staging and BMD assessment by dual energy X-ray absorptiometry of the lumbar spine, and total body. Bone mineral density (in g/cm2) was expressed in Z-scores, the number of standard deviation above or below the mean value of an age- and sex-matched reference population. In children, low BMD was defined as a Z-score less than -2 and osteoporosis was defined as a Z-score less than-2 with a fracture history. The daily intake of calcium was determined by the translated version in Moroccan Arabic language of Fardellone questionnaire. Laboratory evaluations included serum calcium, phosphate, alkaline phosphatase, 25-hydroxyvitamin D were assessed. Results: Forty children with JIA were included (22 male, 18 female); the mean of age of the patients was 11 ± 4.23 years. The median of disease duration was 2 years [1-5]. Eighteen (45%) patients had polyarticular JIA and 60% used corticosteroids.Twenty patients (50%) were given a diagnosis of low BMD and no patient was given a diagnosis of osteoporosis. Bone mineral density Z score in lumbar spine showed a statistically significant correlation with cumulative dose of corticosteroids (β=-0.40, p=0.05) and systemic subtype of JIA (β=-1.07, p=0.01) and the BMD in total body showed a statistically significant correlation with weight (β=0.40, p=0.009) and height (β=0.37, p=0.01). However, there was no significant association in our study between the BMD and disease duration, daily intake of calcium, and 25-hydroxyvitamin D. Conclusion: This study suggests that osteopenia was a frequent complication

Bone mineral density in gravida: effect of pregnancies and breast-feeding in women of differing ages and parity.

Changes of bone during pregnancy and during lactation evaluated by bone mineral density (BMD) may have implications for risk of osteoporosis and fractures. We studied BMD in women of differing ages, parity, and lactation histories immediately postpartum for BMD, T-scores, and Z-scores. Institutional Review Board approval was received. All women while still in hospital postpartum were asked to participate. BMD was performed by dual-energy X-ray absorptiometry (DXA) machine at femoral neck (FN) and lumbar spine (LS) by a single technician. Of 132 participants, 73 (55.3%) were ≤30 years; 27 (20.5%) were primiparous; 36 (27.3%) were grand multiparous; 35 (26.5%) never breast fed. Mean FN T-scores and Z-scores were higher than respective mean LS scores, but all means were within the normal limits. Mean LS T-scores and Z-scores were highest in the grand multiparas. There were only 2 (1.5%) outliers with low Z-scores. We conclude that, in a large cohort of Israeli women with BMD parameters assessed by DXA within two days postpartum, mean T-scores and Z-scores at both the LS and FN were within normal limits regardless of age (20–46 years), parity (1–13 viable births), and history of either no or prolonged months of lactation (up to 11.25 years).

Effect Of Low Dose Bortezomib On Bone Formation In Smoldering Myeloma Patients

BackgroundBortezomib has been shown to produce an anabolic bone effect (increase bone ALP and osteocalcin) in relapsed/refractory patients. This study examined the bone anabolic effect in patients with smoldering multiple myeloma (SMM) who, with a historical median age of 67 years, have frequent evidence of osteopenia not associated with lytic bone disease. SMM is usually followed expectantly without therapy. The overall risk of progression to active MM has been estimated up to 20% in the first year from diagnosis (Kyle et al, 2007). The primary aim of this trial is to determine the effect of a course of low-dose Bortezomib on bone remodeling and on disease progression. MethodsThe dose of bortezomib used in this trial of 0.7mg/m² is the lowest dose which has shown efficacy in the 3 largest monotherapy trials with bortezomib. Patients enrolled in this study had serum M protein ≥ 3 g/dL and/or bone marrow plasma cells ≥ 10% with absence of anemia, renal failure, hypercalcemia, and lytic bone lesions. Patients received 9 cycles of bortezomib given on days 1, 8, 15, 22 every 42 days. No bisphosphonates were allowed during the trial, Vitamin D supplements were allowed. ResultsSeventeen patients (9 males) with a median age of 61 years were enrolled in the study. Fourteen had IgG paraprotein and 3 had an IgA. Two participants did not complete the treatment; the first because of development of a skin rash and the second for personal reasons. A total of 11 patients completed the protocol. Four are still receiving treatment. At the time of this analysis with a median follow-up of 20 months, all patients are alive and none has progressed (Figure 1). The mean M component at baseline, end-of-study, and at most recent follow-up are shown in Figure 2. The treatment was well tolerated by the patients. One patient developed reversible grade 3 neuropathy and a drug related rash and only 3 grade 3 hematological adverse events were recorded (15%). Bone densities by DEXA scan were obtained at baseline, end of study, and yearly thereafter. Out of 17 patients, 13 had bone density T-scores before and after treatment. Six patients (46%) showed an improvement in hip T-score (mean T-score improvement 0.41, range 0.1-1.35). In the overall group, mean T scores improved by 38% (range, 3-200%). T score in lumbar spine improved in 3 patients (23%), who had a mean T-score improvement of 0.2 (range, 0.05-0.43). [Display omitted] [Display omitted] ConclusionsThe use of low dose Velcade in smoldering myeloma patients was well tolerated and produces significant increases in bone density in 46% of participants. Disclosures:Zangari:Millenium Pharm.: Research Funding. Off Label Use: Use of Bortezomib in smoldering myeloma. Salama:Eli Lilly and Co: Research Funding.