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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
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European Journal of Physical and Rehabilitation Medicine 2017 Mar 13

DOI: 10.23736/S1973-9087.17.04452-5

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Disruption in bone marrow fat may attenuate testosterone action on muscle size after spinal cord injury. A case report

Ashraf S. GORGEY 1, 2 , Pamela D. MOORE 1, Rodney C. WADE 1, Ranjodh S. GILL 4, 5, Timothy LAVIS 1, 2, Robert A. ADLER 4, 5

1 Spinal Cord Injury Service and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA; 2 Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA; 3 Radiology Service, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA; 4 Endocrinology Service, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA; 5 Endocrine Division, Virginia Commonwealth University School of Medicine, Richmond, VA, USA


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BACKGROUND: Mesenchymal stem cells can be differentiated into muscle satellite cells. Testosterone replacement therapy (TRT) promotes the differentiation of satellite cells into muscle cells.
CASE REPORT: A 31 year old male with a T4 complete chronic spinal cord injury (SCI) had fixation for a mid-shaft fracture of the left femur. The participant received transdermal testosterone patches (4mg/day) daily for 16 weeks. Skeletal muscle and yellow bone marrow adiposity cross-sectional areas (CSAs) of both thighs were measured using magnetic resonance imaging.
CLINICAL REHABILITATION IMPACT: The yellow bone marrow CSA was 67-69% lower in the left femur compared to the right femur. Following intervention, a discrepancy was noted between the whole skeletal muscle CSAs of the right (+13%) and left (+6%) thighs. The right knee extensor CSA increased by 7% with no changes in the left CSA. Disruption in bone marrow fat may attenuate the systemic effects of TRT on muscle size.


KEY WORDS: Testosterone - Bone marrow - Mesenchymal stem cells - Spinal cord injuries

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ashraf.gorgey@va.gov