Prevalence of reduced bone mass in children and adults with spastic quadriplegia
Article first published online: 13 FEB 2007
Developmental Medicine & Child Neurology
Volume 45, Issue 1, pages 12–16, January 2003
How to Cite
King, W., Levin, R., Schmidt, R., Oestreich, A. and Heubi, J. E. (2003), Prevalence of reduced bone mass in children and adults with spastic quadriplegia. Developmental Medicine & Child Neurology, 45: 12–16. doi: 10.1111/j.1469-8749.2003.tb00853.x
- Issue published online: 13 FEB 2007
- Article first published online: 13 FEB 2007
- Accepted for publication 24th July 2002.
This study was designed to test the hypothesis that non-ambulatory patients with spastic quadriplegia will have reduced bone mass which worsens with increasing age. Forty-eight patients (age 5 to 48 years, median age 15 years; 19 females and 29 males) were studied. Anticonvulsants were used in 29 patients (60.4%). Lumbar spine bone mineral density (LS-BMD) was markedly reduced compared with age-and sex-matched control individuals with a z score of -2.37±0.21. Twenty-eight (58%) had z scores of less than -2. A history of documented previous fracture was present in 19 patients (39%). Patients with a history of fracture had significantly lower (p=0.05) LS-BMD z scores (-2.81±0.29) compared with those without a history of fracture (-2.11±0.26). Mean serum 25-OH vitamin D was 29.6±1.9ng/mL (normal 9 to 37.6ng/mL) with three patients having serum 25-OH vitamin D levels less than 15ng/mL. These findings indicate that BMD is markedly reduced in non-ambulatory children and adults with neuromuscular disease. Reductions in bone mass put them at greater risk for non-traumatic fractures.