Osteoporosis in paediatric patients with spina bifida

The Journal of Spinal Cord Medicine, 2012 · DOI: 10.1179/2045772311Y.0000000042 · Published: January 1, 2012

Neurology Pediatrics Musculoskeletal Medicine

Simple Explanation

Patients with spina bifida (SB) are at increased risk for fractures and low bone mineral density (BMD). This is due to factors like reduced mobility, neurological involvement, and other complications associated with SB. Fractures in patients with SB can result from minor stress or spontaneously. The true incidence is likely higher than recorded due to underrecognition. Preventing osteoporosis and identifying children with established osteoporosis is an important strategy for achieving peak bone mass in patients with SB.

Study Duration

Not specified

Participants

Paediatric patients with spina bifida

Evidence Level

Not specified

Key Findings

1
Patients with SB are at increased risk for fractures and low bone mineral density (BMD).
2
Risk factors include higher levels of neurological involvement, non-ambulatory status, physical inactivity, hypercalciuria, higher body fat levels, contractures, and a previous spontaneous fracture.
3
Most studies did not support an association between a history of fractures and low BMD in young children with SB.

Research Summary

Patients with SB are at increased risk of fractures and low BMD. Risk factors include neurological involvement, non-ambulatory status and physical inactivity. There is limited evidence and consensus on the best methods for osteoporosis prevention and treatment in children with SB. More research is needed. While BMD assessment can be useful, there's no standard approach for measuring BMD in this population, and DXA scans have limitations in SB patients.

Practical Implications

Individualized Fracture Risk Assessment

SB is a complex disease, requiring an individualized approach to fracture risk assessment.

Targeted Interventions

Identify high-risk individuals early on for targeted interventions to prevent multiple fractures.

Further Research

More randomized clinical trials are needed to evaluate the efficacy of osteoporosis treatments in SB patients.

Study Limitations

1
Limited number and quality of studies concerning osteoporosis prevention and treatment in paediatric patients with SB.
2
Lack of studies evaluating the relationship between genetic factors and low BMD in paediatric patients with SB.
3
Most of the articles identified had small sample sizes and lacked the scientific power of clinical trials.

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