Changes in skeletal maturation and mineralization in children with cerebral palsy and evaluation of related factors
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Published on: January 29, 2018
1Department of Pediatrics, Cerrahpaşa Medical Faculty, Istanbul University, Turkey. ilikkan@turk.net
Insights
Children with spastic cerebral palsy often experience delayed skeletal maturation and reduced bone mineralization, particularly in lower extremities. This indicates motor function impairment negatively impacts bone development in pediatric patients.
Area of Science:
- Pediatric Orthopedics
- Developmental Pediatrics
- Radiology
Background:
- Cerebral palsy (CP) is a group of movement disorders due to damage in the developing brain.
- Spastic CP, the most common form, affects muscle tone and movement.
- Skeletal health and maturation can be affected by motor impairments and reduced weight-bearing activity.
Purpose of the Study:
- To investigate bone mineralization and skeletal maturation in children with spastic cerebral palsy.
- To compare bone health parameters between children with CP and healthy controls.
- To explore the relationship between motor function deficits and skeletal development in CP.
Main Methods:
- Dual-energy x-ray absorptiometry (DXA) was used to measure bone mineral content and density.
- Hand and wrist radiographs were analyzed to determine bone age.
- Patients with spastic cerebral palsy were compared to a control group of healthy children.
Main Results:
- Children with spastic cerebral palsy exhibited lower bone mineralization in lower extremities compared to controls and hemiplegics.
- A significant proportion (68%) of patients showed delayed bone age in their left hand and wrist.
- Tetraplegic patients demonstrated the most pronounced deficits in bone mineralization.
Conclusions:
- Motor function handicap adversely affects skeletal mineralization in children with cerebral palsy.
- Skeletal maturation is frequently delayed in children diagnosed with cerebral palsy.
- Hypothesized link between hypoxic brain injury, CP, and disrupted skeletal development warrants further investigation.
Abstract:
Sixty-nine (28 females, 41 males) children with spastic cerebral palsy and 26 (13 females, 13 males) healthy children were included in the study. Total- and partial-body bone mineral content and bone mineral density values of patient and control subjects were measured by dual-energy x-ray absorptiometry. Left hand and wrist radiographs of all patients and right hand and wrist radiographs of 39 randomly selected patients were taken, and the bone ages of all radiographs were determined. In both female and male tetraplegics, bone mineralization values of lower extremities, where the mobility disorder and effects of absence of weight-bearing activity were maximal, were lower than those of controls and hemiplegics (P < .05). In 47 (68%) patients, left-side bone age values were below normal ranges for their ages, and the difference was statistically significant (P < .01). Our results indicate that motor function handicap affects skeletal mineralization adversely, and skeletal maturation is frequently delayed in children with cerebral palsy. We speculated that this delay might be a result of disrupted embryologic skeletal development due to hypoxic attack, which also causes the disease.
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