Biomedical subjects

Tsuyoshi Takeda

Publications and source records attributed to Tsuyoshi Takeda.

54 records · Page 3Linked to original sources

PubMed2003

Effects of cyclical etidronate with alfacalcidol on lumbar bone mineral density, bone resorption, and back pain in postmenopausal women with osteoporosis.

The purpose of the present open-labeled, randomized, prospective study was to compare the effects of cyclical etidronate combined with alfacalcidol with those of cyclical etidronate alone on lumbar bone mineral density (BMD), bone resorption, and back pain in postmenopausal women with osteoporosis. Forty postmenopausal women with osteoporosis, 60-86 years of age, without any vertebral fractures in the lumbar spine, were randomly divided into two groups with 20 patients in each group. One group was treated with cyclical etidronate (oral etidronate 200 mg daily for 2 weeks every 3 months) and the other was given cyclical etidronate combined with alfacalcidol (cyclical etidronate plus alfacalcidol 1 Ig daily continuously). The BMD of the lumbar spine (L1-L4) measured by dual-energy X-ray absorptiometry, urinary crosslinked N-terminal telopeptides of type I collagen (NTX) measured by an enzyme-linked immunosorbent assay, and back pain evaluated by the face scale score were assessed at baseline, 6 months, and 12 months. There were no significant differences in baseline characteristics including age, body mass index, years since menopause, lumbar BMD, urinary NTX level, and face scale score between the two treatment groups. Both treatments significantly reduced the urinary NTX level and back pain. Cyclical etidronate combined with alfacalcidol significantly increased the lumbar BMD with a more significant reduction in the urinary NTX level than cyclical etidronate alone, but cyclical etidronate alone did not significantly increase the lumbar BMD. Alleviation of back pain was similar in the two groups. These results suggest that cyclical etidronate combined with alfacalcidol appears to be more useful than cyclical etidronate alone for increasing the lumbar BMD by more markedly suppressing bone resorption in postmenopausal women with osteoporosis.

Aged↗

PubMed2003

Effects of treatment with etidronate and alfacalcidol for osteogenesis imperfecta type I: a case report.

A case of osteogenesis imperfecta (OI) that was successfully treated with oral etidronate and alfacalcidol is reported. A 36-year-old man with OI type I who had frequently been experiencing fragile fractures in the long bones of the upper and lower extremities presented to our hospital with back pain caused by fragile thoracic vertebral fractures. He was treated with intermittent cyclical etidronate (200 mg/day for 2 weeks per 3 months) and alfacalcidol (1 microgram/day, daily) over 18 months. The bone mineral density of the lumbar spine (L1-L4) measured by dual-energy X-ray absorptiometry (Hologic QDR 1500 W) increased over 18 months, and back pain due to thoracic vertebral fractures markedly decreased. No new fragile vertebral or nonvertebral fractures were observed during the 18 months of treatment. This report provides evidence indicating that treatment with intermittent cyclical oral etidronate and alfacalcidol has potential use in adult patients with OI type I.

Adult↗

PubMed2003

Stress fractures in athletes: review of 196 cases.

The purpose of this study was to investigate the association of stress fractures with age, sex, sport level, sporting activity, and skeletal site in athletes seen at our sports medicine clinic between September 1991 and May 2001. During these 10 years, 10 726 patients (6415 males, 3861 females) visited our clinic because of sport-related injuries, and 196 patients [125 males (1.9%), 71 females (1.8%)] sustained stress fractures. The average age of the patients with stress fractures was 20.1 years (range 10-46 years); 84 patients (42.6%) were 15-19 years of age, and 68 (34.7%) were 20-24 years of age. Altogether, 74 patients (37.8%) were active at the high recreational level and 122 (62.2%) at the competitive level. The sites of the stress fractures varied from sport to sport. The ulnar olecranon was the most common stress fracture site among baseball athletes and the rib among the rowing athletes. Classical ballet, aerobics, tennis, and volleyball athletes predominantly sustained stress fractures of the tibial shaft. Basketball athletes predominantly sustained stress fractures of the tibial shaft and medial malleolus and the metatarsal bone, whereas track and field and soccer athletes predominantly sustained stress fractures of the tibial shaft and pubic bone. Our results show that stress fractures are seen even in high-level adolescent athletes, with similar proportions for males and females, and that particular sports are associated with specific sites for stress fractures.

Adolescent↗

PubMed2003

Effect of vitamin K2 on cortical and cancellous bones in orchidectomized and/or sciatic neurectomized rats.

We examined the effect of vitamin K2 on cortical and cancellous bones in orchidectomized and/or sciatic neurectomized rats. Ninety male Sprague-Dawley rats, 3 months of age, were randomized by stratified weight method into nine groups with 10 rats in each group: baseline control (BLC), age-matched intact control (IN), IN+vitamin K2 administration (K), orchidectomy (ORX), ORX+K, unilateral sciatic neurectomy (NX), NX+K, ORX+NX (ONX), and ONX+K. Vitamin K2 (menatetrenone) was administered orally twice a week at a dose of 30 mg/kg each. After 10 weeks of feeding, the tibial shaft and proximal tibia were processed for cortical and cancellous bone histomorphometric analyses, respectively. An ORX-induced reduction in maturation-related cortical bone gain and ORX-induced cancellous bone loss were attributable to increased endocortical and trabecular bone turnover, respectively. NX- and ONX-induced reductions in maturation-related cortical bone gain were attributable to decreased periosteal bone formation and increased endocortical bone turnover, while NX- and ONX-induced cancellous bone loss was attributable to increased bone resorption and decreased bone formation. ORX-induced cancellous bone loss was more pronounced when combined with immobilization. Vitamin K2 administration did not significantly alter any parameters in IN rats. Vitamin K2 administration in ORX rats suppressed endocortical bone resorption and trabecular bone turnover, retarding a reduction in maturation-related cortical bone gain and cancellous bone loss. This effect on cancellous bone loss was primarily because of prevention of a reduction of trabecular thickness. Vitamin K2 administration in NX and ONX rats suppressed bone resorption and stimulated bone formation (mineralization), with retardation of a reduction of trabecular thickness without any significant effect on cancellous bone mass, and suppressed endocortical bone resorption, retarding a reduction in maturation-related cortical bone gain. The present study provides evidence indicating that vitamin K2 has the potential to suppress bone resorption or bone turnover and/or stimulate bone formation in vivo in ORX and/or NX rats.

Animals↗

PubMed2003

Early response to alendronate after treatment with etidronate in postmenopausal women with osteoporosis.

The purpose of the present study was to examine the early response of lumbar bone mineral density (BMD), bone resorption, and back pain to alendronate after treatment with cyclical etidronate in postmenopausal women with osteoporosis. Forty postmenopausal women with osteoporosis, 60-83 years of age, without any vertebral fractures in the lumbar spine, were randomly divided into two groups with 20 patients in each group: 18 months of cyclical etidronate (200 mg daily for 2 weeks every 3 months) group and 12 months of cyclical etidronate followed by 6 months of alendronate (5 mg daily) group. BMD of the lumbar spine (L1-L4) measured by DXA, urinary cross-linked N-terminal telopeptides of type I collagen (NTX) level measured by enzyme-linked immunosorbent assay, and back pain evaluated by face scale score were assessed at baseline and every 6 months. There were no significant differences in baseline characteristics including age, body mass index, years since menopause, lumbar BMD, urinary NTX level, and face scale score between the two groups. Cyclical etidronate significantly reduced urinary NTx level and face scale score over 12 months, but did not significantly increase lumbar BMD. After 12 months of treatment, the switch to alendronate significantly reduced urinary NTX level and face scale score, and significantly increased lumbar BMD, while continued cyclical etidronate did not significantly alter these parameters. These results suggest that switching to alendronate after treatment with cyclical etidronate produces a greater response of lumbar BMD, bone resorption, and back pain than continued cyclical etidronate in postmenopausal women with osteoporosis.

Aged↗

PubMed2003

Treatment with vitamin D3 and/or vitamin K2 for postmenopausal osteoporosis.

It is established in Japan that treatment with 1alpha-hydroxyvitamin D3 (alfacalcidol) slightly reduces bone turnover, sustains lumbar bone mineral density (BMD), and prevents osteoporotic vertebral fractures in postmenopausal women with osteoporosis, while vitamin K2 (menatetrenone) enhances gamma-carboxylation of bone glutamic acid residues and secretion of osteocalcin, sustains lumbar BMD, and prevents osteoporotic fractures in patients with osteoporosis. Available evidence suggests that the effect of vitamin K2 on mineralization by human periosteal osteoblasts is enhanced in the presence of 1,25 dihydroxyvitamin D3 in vitro. The effect of vitamin K2 on BMD in ovariectomized rats is affected by the plasma 25-hydroxyvitamin D3 level in vivo, and is significant only when rats are fed a diet containing vitamin D3. Based on this line of evidence, combined treatment with alfacalcidol and menatetrenone for osteoporosis is surmised to be more effective than treatment with menatetrenone alone, and may have anabolic effects on osteoporotic bone. This combined treatment may increase bone formation as well as bone resorption over the mild anti-resorptive effect of alfacalcidol itself, and shows the greatest effect on lumbar BMD or the incidence of vertebral fractures in studies in which the mean age and years since menopause of subjects were low and the degree of osteoporosis was mild. It may be effective for mild postmenopausal osteoporosis in which age-related deterioration of trabecular bone properties remains below the threshold for vertebral fractures, even if bone resorption is increased and trabecular bone has deteriorated.

Animals↗

PubMed2003

Comparative effects of treatment with etidronate and alendronate on bone resorption, back pain, and activities of daily living in elderly women with vertebral fractures.

The purpose of the present study was to compare the effects of treatment with etidronate and alendronate on bone resorption, back pain, and activities of daily living (ADL) in elderly women with vertebral fractures. Fifty elderly women, 63-84 years of age, with back pain due to osteoporotic vertebral fractures were randomly divided into two groups with 25 patients in each group: the cyclical etidronate treatment group (200 mg/day for 2 weeks per 3 months) and the alendronate treatment group (5 mg/day). The level of urinary cross-linked N-terminal telopeptides of type I collagen (NTx) measured by an enzyme-linked immunosorbent assay, back pain evaluated with the face scale score, and the ADL score (disability) determined with a questionnaire were assessed before and 3 and 6 months after the start of treatment. No significant differences in these parameters were found between the two groups before the treatment. The urinary NTx level, the face scale score, and the ADL score decreased significantly in both groups. Although the reduction in the urinary NTx level was significantly greater in the alendronate group than in the etidronate group, the reduction in the face scale score was transiently significantly greater in the etidronate group than in the alendronate group. However, changes in the ADL score did not significantly differ between the two groups. The present study showed that although back pain was reduced and ADL was improved in both treatment groups of elderly women with vertebral fractures, the mechanism for the reduction in back pain differs to some extent between the two treatment groups. A double-blind placebo-controlled study is needed to confirm the therapeutic effects of these agents on back pain and deterioration of ADL.

Activities of Daily Living↗

PubMed2002

Increased bone resorption with decreased activity and increased recruitment of osteoblasts in osteogenesis imperfecta type I.

An iliac bone biopsy from an adult male, 58 years of age, with osteogenesis imperfecta type I was studied by bone histomorphometry after double-fluorescence labeling with tetracycline. Low bone mineral density (BMD) of the radius, measured by dual-energy X-ray absorptiometry (DXA) was associated with high levels of urinary deoxypyridinoline and serum bone-specific alkaline phosphatase and osteocalcin. At the tissue level, low cancellous bone volume (BV/TV) was associated with increased eroded surface (ES/BS) and a relatively increased osteoclast number (N.Oc/BS). Osteoid thickness (O.Th) was also decreased as a result of decreased bone matrix synthesis, in terms of decreased osteoblastic activity. However, osteoid surface (OS/BS) and osteoblast surface (ObS/BS), in terms of the number of osteoblasts, were increased. We conclude that the patient showed cancellous osteopenia, which was likely due to increased bone resorption with decreased activity and increased recruitment of osteoblasts.

Absorptiometry, Photon↗

PubMed2002

Transient relief of metastatic cancer bone pain by oral administration of etidronate.

The aims of the present study were to determine whether patients with painful bone metastases from primary cancer sites showed a higher level of a bone resorption marker than those with no evidence of skeletal-related events, and to clarify the efficacy of oral administration of etidronate for pain due to bone metastases and bone resorption. Thirty outpatients with cancer were recruited: 10 with pain due to bone metastasis from the primary cancer site; lung (4), prostate (3), and breast (3) (M group), and 20 with primary cancer of the stomach (11), colon (4), breast (3), lung (1), and bladder (1) with no such evidence of skeletal-related events (non-M group). None of the patients in the M group either needed morphine for pain relief or had hypercalcemia, although all of them had been taking nonsteroidal anti-inflammatory drugs (NSAIDs). During the study, they continued taking NSAIDs, as they had before the study. The level of urinary cross-linked N-telopeptides of type I collagen (NTx) at baseline was significantly higher in the M group than in the non-M group ( P < 0.01). Oral administration of etidronate (400 mg/day for 2 weeks) to patients in the M group significantly reduced bone pain 2 and 12 weeks after the start of treatment; however, the pain relief effect was diminished 12 weeks after the start of treatment, despite a significant decrease in urinary NTx level ( P < 0.05 by one-way analysis of variance [ANOVA] with repeated measurements). The present study provides evidence suggesting that patients with painful bone metastases from primary cancer sites may have a higher level of urinary NTx than those with no evidence of skeletal-related events, and that oral administration of etidronate at the dose we used may have the potential to transiently relieve their bone pain by decreasing abnormally raised bone resorption. Although the present study had a small sample size, and had no placebo controls, the results may be useful, especially as they raise additional questions that could stimulate further research in Japan.

Administration, Oral↗

PubMed2002

Effect of decreased physical activity on bone mass in exercise-trained young rats.

The aim of this study was to determine whether decreased physical activity in exercise-trained young rats would result in a lower rate of bone gain or a reversal of the benefits of exercise. Thirty-five female Wistar rats, 6 weeks of age, were randomized into seven groups: 7 weeks of exercise (7EX), 7 weeks of sedentary control (7CN), 11 weeks of exercise (11EX), 7 weeks of exercise followed by 4 weeks of exercise cessation (7EX4C), 7 weeks of exercise followed by 4 weeks of decreased exercise frequency (7EX4F), 7 weeks of exercise followed by 4 weeks of decreased exercise intensity (7EX4I), and 11 weeks of sedentary control (11CN). The running intensity (speed) and duration were 25 m/min for 60 min/day at a frequency of 5 days/week. During the last 4 weeks, exercise frequency was reduced to 1 day/week in the 11EX4F group, and exercise intensity (speed) was reduced to 12 m/min in the 7EX4I group. After each period of exercise, the bone mineral content (BMC) of the proximal, middle, and distal tibiae, determined by dual-energy X-ray absorptiometry (DXA), was significantly greater in the 7EX and 11EX groups than in the 7CN and 11CN groups, respectively, but it was significantly lower in the 7EX4C group than in the 11EX group and did not differ significantly from the values of the 11CN group. Although the BMC of the proximal and middle tibiae did not differ significantly among the 7EX4F, 7EX4I, 7EX4C, and 11CN groups, the BMC of the distal tibia was significantly greater in the 7EX4F and 7EX4I groups than in the 11CN group and tended to be greater than in the 7EX4C group. The results of this study suggest that the effect of decreased exercise intensity and frequency on bone mass appears to be site specific in the tibia of the exercise-trained young rats. This study shows that exercise-trained young rats lose the benefits gained from exercise when exercise is completely ceased, resulting in the reduction of bone mass to levels that do not differ significantly from those of sedentary controls. At least, continuous exercise appears to be necessary for the maintenance of high bone mass.

Absorptiometry, Photon↗

PubMed2002

Comparative effects of intermittent administration of human parathyroid hormone (1-34) on cancellous and cortical bone loss in tail-suspended and sciatic neurectomized young rats.

We compared the effects of intermittent administration of human parathyroid hormone (PTH) (1-34) on tibial cancellous and cortical bone loss in tail-suspended and sciatic neurectomized young rats. Forty-eight 6-week-old male Wistar rats were randomly divided into six groups with eight animals each: age-matched controls (AMC), tail suspension (TS), sciatic neurectomy (NX), AMC + PTH, TS + PTH, and NX + PTH. Fifteen days after the start of the experiment, the proximal tibia and tibial shaft were processed for cancellous and cortical bone histomorphometric analyses, respectively. The reduction of cancellous bone volume (BV/TV) was significantly greater in the TS group than in the NX group, whereas the reduction of percent cortical area (Ct Ar) did not differ significantly between the TS and NX groups. Administration of human PTH to rats in the TS and NX groups increased BV/TV to a level significantly higher than that of the AMC group. Administration of human PTH to rats in the NX group significantly increased percent Ct Ar, but percent Ct Ar of the NX group was still significantly lower than that of the AMC group. Administration of human PTH to rats in the TS group did not significantly affect percent Ct Ar. These findings suggest that intermittent administration of human PTH (1-34) at the dose we used may completely prevent cancellous bone loss both in TS and NX young rats, and that it may not affect cortical bone loss in TS young rats but only attenuate it in NX young rats.

Alkaline Phosphatase↗

PubMed2002

Forearm bone mineral density in patients with rheumatoid arthritis.

The aims of the present study were to determine whether patients with rheumatoid arthritis (RA) show significantly lower forearm bone mineral density (BMD) than sex- and age-matched healthy controls, and to identify significant factors that are associated with their BMD loss. One hundred eighty-four patients with RA and 185 sex- and age-matched healthy controls were enrolled in the study: 71 men 37-68 years of age (RA, 31; controls, 40), 129 premenopausal women 30-48 years of age (RA, 67; controls, 62), and 169 postmenopausal women 48-69 years of age (RA, 86; controls, 83). The correlation of forearm BMD, measured by dual energy X-ray absorptiometry with anatomic grade in the wrist, functional class, duration of disease, steroid use, modified health assessment questionnaire (HAQ) score for the upper and lower extremities, levels of serum C-reactive protein and rheumatoid factor, erythrocyte sedimentation rate, and years since menopause (YSM) were examined by multiple regression analysis. In men with RA, no clinical factors were significantly correlated with forearm BMD, and the BMD did not differ significantly from that in controls (0.329 +/- 0.060 [mean +/- SD] vs. 0.351 +/- 0.069 g/cm(2)). In premenopausal women with RA, the HAQ score for the upper extremities was positively correlated with forearm BMD ( P < 0.05), but the BMD did not differ significantly from that in controls (0.298 +/- 0.085 vs. 0.324 +/- 0.088 g/cm(2)); in postmenopausal women with RA, YSM and anatomic grade in the wrist were negatively correlated with forearm BMD ( P < 0.01 and P < 0.05), and the BMD was significantly lower than in controls (0.192 +/- 0.063 vs. 0.223 +/- 0.076 g/cm(2), P < 0.01). These findings suggest that forearm BMD loss in patients with RA may be accelerated in women after menopause, and that YSM and disuse of the wrist may be significant determinants of their forearm BMD loss.

Absorptiometry, Photon↗

PubMed2002

Effects of 5-year treatment with elcatonin and alfacalcidol on lumbar bone mineral density and the incidence of vertebral fractures in postmenopausal women with osteoporosis: a retrospective study.

The purpose of this retrospective study was to compare the effects of long-term treatment (5 years) with elcatonin and alfacalcidol on bone mineral density (BMD) and the incidence of vertebral fractures in postmenopausal women with osteoporosis. Fifty-six osteoporotic women, more than 5 years after menopause and 58-79 years of age, were enrolled in the study and allocated to an elcatonin treatment group (20 units IM, weekly; n = 30) or an alfacalcidol treatment group (1 micro g/day, daily; n = 26). BMD of the lumbar spine (L2-L4) was measured by dual energy X-ray absorptiometry at baseline and every year for 5 years. There were no significant differences in age, body mass index, years since menopause, BMD, or number of prevalent vertebral fractures at baseline between the two groups. One-way analysis of variance with repeated measurements showed no significant longitudinal changes in BMD in either group, suggesting that both treatments sustained the BMD over 5 years. Two-way analysis of variance with repeated measurements also showed no significant differences in longitudinal changes in BMD between the two groups, suggesting that the effects of the two treatments on BMD were similar. However, the number of incident vertebral fractures per patient was significantly lower in the alfacalcidol treatment group than in the elcatonin treatment group (0.80 +/- 1.19 and 2.08 +/- 2.73, respectively; P < 0.05). These findings indicate that both treatments appeared to sustain lumbar BMD similarly over a 5-year period in postmenopausal women with osteoporosis, but alfacalcidol treatment may be superior to elcatonin treatment regarding the incidence of vertebral fractures. Further study with prospective observations are needed to confirm the results of the present study.

Aged↗

PubMed2002

Insufficiency fracture of the femoral neck during osteoporosis treatment: a case report.

Acase of insufficiency fracture of the femoral neck that occurred during treatment for osteoporosis is reported. A 77-year-old woman (height 150 cm, body weight 43 kg) with osteoporosis associated with high bone turnover was treated with oral cyclical etidronate (400 mg/day for 2 weeks every 3 months). Three months after the treatment was started the patient experienced pain in the right hip joint while walking despite no evidence of trauma. Although radiographs were normal, weight-bearing was not possible because of pain. T2-weighted magnetic resonance (MR) imaging was used to detect a fracture line localized on the inferior aspect of the femoral neck. Because on bone marker measurement bone resorption was increased and bone formation was decreased from baseline, treatment was switched to oral alendronate (5 mg/day, daily). Pain resolved 3 weeks after the fracture was evident, and free gait was possible during the following 3 weeks. Follow-up radiographs, obtained 3 and 6 months after the fracture was evident, showed bony sclerosis on the aspect in which the fracture line was observed on the T2-weighted MR image. The dissociation (imbalance) of bone formation and resorption was also alleviated. A possibility of increased bone fragility should be kept in mind when oral cyclical etidronate is applied to elderly Japanese, small-physique women with osteoporosis at a daily dose of 400 mg (higher dose).

Administration, Oral↗

PubMed2002

Relationships among physical activity, metacarpal bone mass, and bone resorption marker in 70 healthy adult males.

The purpose of the present study was to investigate the relationships among physical activity, metacarpal bone mineral density (BMD), and bone resorption marker in healthy active adult men. Seventy healthy men (mean age, 68.4 years, range, 48-85 years) were recruited. The metacarpal BMD of the nondominant hand was measured by computed X-ray densitometry, and the levels of urinary cross-linked N-telopeptides of type I collagen (NTx), as a marker of bone resorption, were measured with an enzyme-linked immunosorbent assay. The relationships among BMD, urinary NTx levels, and activities in leisure time and at work were examined. BMD was 2.77 +/-0.48 (mean+/- SD; range, 1.54-3.60) mmAl, and NTx levels were 44.9 +/-21.0 (range, 11.7 - 91.0) nmol BCE/mmol creatinine. Single regression analysis showed that BMD was significantly correlated with NTx levels and activity at work (r = - 0.331 and P < 0.01; r = 0.468 and P < 0.05, respectively), while NTx levels were significantly correlated with activities in leisure time and at work (r = -0.250 and P < 0.01; r = -0.325 and P < 0.01, respectively). NTx levels were decreased and BMD were increased with higher activity at work. The present study shows that increased physical activity as a result of hard work may have the potential to decrease bone resorption and increase BMD in healthy adult men.

Age Distribution↗

PubMed2002

Forearm bone mineral density in postmenopausal women with osteoarthritis of the knee.

The aims of the present study were to clarify whether postmenopausal women with osteoarthritis (OA) of the knee show higher bone mineral density (BMD) than healthy controls, and to investigate the relationship between BMD and the Kellgren and Lawrence radiological grade in postmenopausal women with OA of the knee. A total of 674 postmenopausal women, 46-90 years of age, were enrolled in the study: 305 patients with OA of the knee and 369 healthy controls. Forearm (distal radius) BMD, measured by dual-energy X-ray absorptionetry (DXA), using a DTX-200 (Osteometer), was significantly higher in the OA group than in the control group (P < 0.001), even when adjusted for age, height, body weight, body mass index, years since menopause, and grip strength (P < 0.01). Analysis of variance (ANOVA) with Fisher's protected least significant difference (PLSD) test showed that BMD in radiological grades 2, 3, and 4 was significantly higher than that in grade 1 (P < 0.05, P < 0.001, and P < 0.05, respectively), and BMD in grade 3 was significantly higher than that in grade 2 (P < 0.01), but BMD in grade 4 was significantly lower than that in grade 3 (P < 0.05). These findings suggest that forearm BMD appears to be significantly higher in postmenopausal women with OA of the knee than in healthy controls. Although BMD may be increased in low to moderate radiological grades of OA, severe grade OA may not always develop from moderate grade OA. Some cases of severe grade OA may be associated with low BMD.

Aged↗

PubMed2002

Effect of surgical treatment on physical activity and bone resorption in patients with neurogenic intermittent claudication.

The effect of surgical treatment on physical activity and bone resorption was examined in patients with neurogenic intermittent claudication. Nineteen patients, 50-77 years of age, with neurogenic intermittent claudication (mean, 162 m; range, 20-400 m) caused by degenerative lumbar disease were included in the study. Decompressive laminectomy alone was performed for 7 patients with lumbar spinal stenosis (LSS) and 5 patients with degenerative lumbar spondylolisthesis (DLSL), and decompressive laminectomy, with a Graf stabilization system, was performed for 7 patients with DLSL associated with flexion instability. Clinical symptoms and levels of urinary cross-linked N-telopeptides of type I collagen (NTx) were assessed before and 12 months after surgery. Subjective symptoms, including low back pain, leg pain and/or tingling, and gait disturbance, as well as restriction of activities of daily living were significantly alleviated by the surgical treatment, resulting in an increase in physical activity. Urinary NTx levels were significantly decreased by the surgical treatment, from 63.1 +/- 16.9 (mean +/- SD) nmol BCE/mmol Cr to 52.1 +/-11.2 nmol BCE/mmol Cr (P < 0.05). These findings suggest that surgical treatment appears to alleviate the clinical symptoms and increase physical activity in patients with LSS or DLSL, potentially resulting in the suppression of bone resorption. Surgical treatment may contribute to the prevention of physical inactivity-induced osteoporosis in elderly patients with neurogenic intermittent claudication caused by degenerative lumbar disease.

Aged↗

PubMed2002

Beneficial effect of etidronate on bone loss after cessation of exercise in postmenopausal osteoporotic women.

OBJECTIVES: To determine whether etidronate could prevent or restore bone loss after cessation of exercise in postmenopausal osteoporotic women. DESIGN: Thirty-five postmenopausal osteoporotic women were studied. Exercise consisted of daily brisk walking and gymnastic training. The changes in the lumbar bone mineral density measured by dual energy x-ray absorptiometry were assessed. RESULTS: One or two years of exercise increased the bone mineral density from the baseline. One year of cessation of exercise after 1 yr of exercise resulted in the loss of the bone mineral density gained through exercise. Two years of cyclical etidronate treatment from year 2 sustained the bone mineral density during 2 yr of cessation of exercise in the preventative etidronate treatment group and completely restored the loss of bone mineral density after 1 yr of cessation of exercise in the therapeutic etidronate treatment group. CONCLUSIONS: Cyclical etidronate treatment, when exercise is discontinued, seems to be beneficial for the prevention or restoration of bone loss after cessation of exercise in postmenopausal osteoporotic women. Although the present study has a small sample size, the results may be interesting, especially because they raise additional questions that could stimulate further research.

Absorptiometry, Photon↗