title: Regional changes in bone mineral density following spinal cord injury in children.
abstract: OBJECTIVE
  To document the serial changes in bone mineral density (BMD) following paediatric spinal cord injury (SCI).
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Paediatric tertiary care hospital.
  
  
  METHODS
  Eighteen children (nine males) followed in an outpatient spinal cord injury service.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Serial bone mineral density (BMD) measurements using dual energy X-ray absorptiometry (DXA).
  
  
  RESULTS
  Mean follow-up was 5.0 +/- 3.6 years (range 0.4-12.4 years). Three children sustained minimal trauma fractures, all femoral. For the cohort, BMD Z-scores were significantly less than zero in the legs (-2.7 +/- 2.0, p < 0.001), femoral neck (-2.1 +/- 1.4, p < 0.001), total body (-0.8 +/- 1.3, p=0.02) and lumbar spine (-0.8 +/- 1.6, p=0.04), but not in the arms (-0.2 +/- 1.0, p=0.5). Lean tissue mass (LTM) Z-scores were reduced in the legs (-1.9 +/- 1.3, p < 0.001). Longitudinal data showed an initial decline in lower extremity BMD, BMC and LTM aged-matched Z-scores in the 12 months following SCI, followed by an age appropriate increase thereafter.
  
  
  CONCLUSIONS
  Lower extremity osteopenia and sarcopenia develop rapidly in the first 12 months following the SCI. The reduced bone strength increases the risk of low trauma fracture.
authors.affiliation: Department of Paediatrics, Nepean Hospital, Nepean Clinical School, University of Sydney, New South Wales, Australia.
authors.forename: Anthony J W
authors.initials: AJ
authors.lastname: Liu
authors.forename: Julie N
authors.initials: JN
authors.lastname: Briody
authors.forename: Craig F
authors.initials: CF
authors.lastname: Munns
authors.forename: Mary-Clare A
authors.initials: MC
authors.lastname: Waugh
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D015519:Bone Density; D016723:Bone Remodeling; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012044:Regression Analysis; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D018709:Statistics, Nonparametric; D013997:Time Factors