Bone density in myelomeningocele: the effects of ambulatory status and other factors.
Measurements were made of distal radius, mid-radius, tibia and metatarsal bone-density of 80 patients with myelomeningocele (17 thoracic, six L1/L2, 13 L3, 30 L4, 14 L5/sacral). For the upper extremity the bone density primarily was low in the thoracic patients, but in the tibia and metatarsal it showed a more linear correlation with neurological levels. The effect of age was highly significant at all sites; after controlling for this, the neurological level was a significant determinant of bone density at all sites, and this effect was greater in older children. Patients with impaired ambulation had decreased bone-density in the distal radius, tibia and metatarsal, but not in the mid-radius. Race had no significant effect on density after accounting for differences in neurological level. Weight for height and multiple fractures did not correlate with bone density. Although ambulatory status (weight-bearing stresses) and neurological status (muscle stresses) are both important factors in bone density, this study suggests that the latter is a more important determinant.
Rosenstein
B D
BD
University of North Carolina School of Medicine, Chapel Hill 27514.
Greene
W B
WB
Herrington
R T
RT
Blum
A S
AS
D000293:Adolescent; D000328:Adult; D001835:Body Weight; D001846:Bone Development; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008591:Meningomyelocele / Q000503:physiopathology* / Q000601:surgery; D008682:Metatarsal Bones / Q000032:analysis / Q000503:physiopathology; D011884:Radius / Q000032:analysis / Q000503:physiopathology; D013977:Tibia / Q000032:analysis / Q000503:physiopathology