Quantitative Computed Tomography of Vertebral Spongiosa: A Sensitive Method for Detecting Early Bone Loss After Oophorectomy

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Abstract
The bone mineral loss was assessed serially in 37 premenopausal women for 24 mo. after oophorectomy and the dose-response determined for conjugated estrogen therapy in preventing this loss. Spinal cancellous bone was measured by quantitative computed tomography and measurement of appendicular cortical bone by radial photon absorptiometry and metacarpal radiogrammetry. For the placebo and low-dose treatment groups, the mean annual bone mineral losses were 7-9% from the vertebral spongiosum and 1-3% from the peripheral cortex. The correlation between axial and appendicular loss was weak (r = 0.581), precluding a reliable estimate of spinal loss from peripheral measurements. For the maximal-dose group (0.6 mg/day) the mean annual bone mineral losses were less than 0.5% from the axial and appendicular sites, and were not significant. Spinal quantitative computed tomography provides a highly sensitive measurement of bone mineral loss after oophorectomy, bone mineral loss is 5- to 7-fold greater from the spinal spongiosum than from the appendicular cortex, and conjugated estrogen in doses of less than 0.6 mg/day are inadequate to prevent the vertebral mineral loss.