ORIGINAL ARTICLE Analysis of the evolution of cortical and trabecular bone compartments in the proximal femur after spinal cord injury by 3D-DXA L. Gifre 1,2 & L. Humbert 3 & A. Muxi 4 & L. Del Rio 5 & J. Vidal 6 & E. Portell 6 & A. Monegal 1 & N. Guañabens 1 & P. Peris 1 Received: 12 April 2017 /Accepted: 11 October 2017 # International Osteoporosis Foundation and National Osteoporosis Foundation 2017 Abstract Summary Marked trabecular and cortical bone loss was observed at the proximal femur short-term after spinal cord injury (SCI). 3D-DXA provided measurement of vBMD evolution at both femoral compartments and cortical thinning, thereby suggesting that this technique could be useful for bone analysis in these patients. Introduction SCI is associated with a marked increase in bone loss and risk of osteoporosis development short-term after injury. 3D-DXA is a new imaging analysis technique providing 3D analysis of the cortical and trabecular bone from DXA scans. The aim of this study was to assess the evolution of trabecular macrostructure and cortical bone using 3D-DXA in patients with recent SCI followed over 12 months. Methods Sixteen males with recent SCI (< 3 months since injury) and without antiosteoporotic treatment were included. Clinical assessment, bone mineral density (BMD) measurements by DXA, and 3D-DXA evaluation at proximal femur (analyzing the integral, trabecular and cortical volumetric BMD [vBMD] and cortical thickness) were performed at baseline and at 6 and 12 months of follow-up. Results vBMD significantly decreased at integral, trabecular, and cortical compartments at 6 months (- 8.8, - 11.6, and - 2.4%), with a further decrease at 12 months, resulting in an overall decrease of - 16.6, - 21.9, and - 5.0%, respectively. Cortical thickness also decreased at 6 and 12 months (- 8.0 and - 11.4%), with the maximal decrease being observed during the * P. Peris pperis@clinic.ub.es L. Gifre lgifre.germanstrias@gencat.cat L. Humbert ludovic.humbert@galgomedical.com A. Muxi amuxi@clinic.ub.es L. Del Rio ldelrio@cetir.es J. Vidal jvidal@guttmann.com E. Portell eportell@guttmann.com A. Monegal amonegal@clinic.ub.es N. Guañabens nguana@clinic.cat 1 Rheumatology Department, Hospital Clinic of Barcelona, IDIBAPS, CIBERehd, Metabolic Bone Diseases Unit, Service of Rheumatology, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain 2 Present address: Rheumatology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain 3 Galgo Medical, Barcelona, Spain 4 Nuclear Medicine Department, Hospital Clínic of Barcelona, Barcelona, Spain 5 CETIR, Barcelona, Spain 6 Guttmann Neurorehabilitation Institute, Universitat Autònoma de Barcelona, Badalona, Spain Osteoporos Int https://doi.org/10.1007/s00198-017-4268-9