Peripheral Quantitative Computed Tomography
Volumetric bone mineral density is assessed using peripheral quantitative computed tomography (pQCT). Peripheral QCT is a safe and precise technique to differentiate cortical from trabecular bone and assess both bone geometry and volumetric density. Histomorphometry measures bone biopsies and analyzes it at the tissue and cellular level to provide an in-depth understanding.
However it is not always feasible to do histomorphometry because it requires taking surgically removed bone specimens from willing participants.
It is important to note that all of these outcomes are secondary and tertiary surrogates for bone strength. A primary measure of bone health is fracture reduction, however, this requires studies with large numbers of participants, followed for an extended period of time. This has been difficult to achieve with individuals with SCI. To date, there have not been any clinical trials to test interventions or studies large enough to investigate fracture reduction in this population.