Assessment of bone density in patients with scoliosis neuromuscular secondary to cerebral palsy

Júnior, Charbel Jacob; Barbosa, Igor Machado; Júnior, José Lucas Batista; Leonel, Rayana Bomfim; Perim, Larissa Grobério Lopes; Oliveira, Tarcísio Guimarães Silva

doi:10.1590/s1808-18512014130300r80

Cited by 6 publications

(1 citation statement)

References 14 publications

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“…Several further studies have shown low BMD values in children with CP, with results ranging from 68% to 97% of the examined children [ 23 – 27 ]. In our study, based on the latest recommended diagnostic criteria [ 23 , 26 , 27 ], all of the examined children had osteopenia, i.e., reduced BMD, and 23.33% of them had osteoporosis. A percentage this high could be explained, by the families of the patients living in less-developed areas of our country, and that the majority of patients grew in poor conditions, which had a significant impact on nutrition and care of the children [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 77%

Measurement of Bone Mineral Density in Children with Cerebral Palsy from an Ethical Issue to a Diagnostic Necessity

Nurković

Petković

Tiosavljević

et al. 2020

BioMed Research International

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Introduction. Due to concerns about cumulative radiation exposure in the pediatric population, it is not standard practice to perform dual-energy X-ray absorptiometry (DXA) analysis in the diagnostic process of musculoskeletal disorders, such as cerebral palsy (CP). This study aimed to evaluate the bone mineral density (BMD) in children with CP and the ethical justification of applying DXA analysis in these children. Material and Methods. In this monocentric retrospective analysis, data were collected from children and adolescents with CP who were treated for a primary illness for three years. A clinical examination, which included a DXA analysis, recommended by the multidisciplinary team, was performed. After applying inclusion and exclusion criteria, 60 scans remained for statistical analysis. BMD and Z-scores for the lumbar spine (LS), and hip right and left femoral neck (RFN and LFN, respectively), and total hip (TH) were recorded. Results. The average age of children with CP when DXA analysis was first performed was about 7 years. The BMD (mean±SD) at LS (LS-BMD) of all patients was 0.612±0.12, at RFN 0.555±0.11, at LFN 0.572±0.1, and at TH (TH-BMD) 0.581±0.13. The values of the Z-score (mean±SD) at LS of all patients were −2.5±0.22, at RFN −2.2±0.21, at LFN -2.25 (SD=0.2), and at TH -2.3 (SD=0.23). There was no statistical significance between age and gender; however, BMI, walking ability, fracture history, and pattern of CP had a significant impact on BMD and Z-score values of these children. Conclusion. The results of our study clearly indicate that children with CP have a higher risk of low BMD, osteoporosis, and bone fractures, which makes it ethically justifiable to perform the DXA analysis in these children.

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