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Updated: Jul 8, 2025
Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Bone health in children with severe cerebral palsy
Vincent Barbier1,2,3,4, Vincent Goeb5, Richard Gouron4,6
1Department of Paediatric Physical Medicine and Rehabilitation, Amiens University Hospital and Jules Verne University of Picardie, Amiens, France.
Insights
Children with severe cerebral palsy exhibit poor bone health, with low bone mineral density likely due to excessive bone remodeling. Management should address underweight and delayed puberty, potentially with calcium and vitamin D supplementation.
Area of Science:
- Pediatric Endocrinology
- Orthopedics
- Bone Metabolism
Background:
- Severe cerebral palsy (CP) is associated with significant motor impairments.
- Bone health complications are common in children with CP, impacting their quality of life and long-term prognosis.
Purpose of the Study:
- To characterize bone health status in children with severe CP.
- To identify factors associated with bone health in this population.
Main Methods:
- Retrospective, single-center study.
- Comprehensive bone evaluation including clinical assessment, bone mineral density (BMD) measurements (BMC and BMD Z scores for total body less head and lumbar spine), and bone biomarker analysis.
- Statistical analysis to determine relationships between bone health parameters and clinical factors (age, weight, pubertal stage).
Main Results:
- All 19 children with severe CP had abnormal bone mineral content (BMC) Z scores.
- A high prevalence of low bone mineral density (BMD) was observed, with only one child having a BMD Z score greater than -2 for total body less head.
- Bone biomarker data indicated excessive bone remodeling, though marker levels did not correlate with densitometric variables. Age, weight, and pubertal stage were significantly associated with bone mass.
Conclusions:
- Children with severe CP demonstrate insufficient bone mass accrual with age, potentially linked to excessive bone remodeling.
- Low bone mineral density is highly prevalent in this cohort.
- Interventions such as calcium and vitamin D supplementation, alongside management of underweight and delayed puberty, may be beneficial. Bone remodeling markers may aid in monitoring.
Aim:
To describe bone health and associated factors in children with severe cerebral palsy.
Method:
In a retrospective, single-centre study, we performed a comprehensive bone evaluation (including clinical, densitometric and bone biomarker assessments) of children with severe cerebral palsy.
Results:
None of the 19 included children had a normal BMCTBLH Z score, and only one had a BMDTBLH Z score greater than -2. Six children had a BMDLS Z score greater than -2. The bone biomarker data were suggestive of excessive bone remodelling. Levels of bone remodelling markers factors and densitometric variables were not significantly related. Age, weight and pubertal stage were significantly related to bone mass.
Discussion:
Our results highlights the insufficient increase in bone mass with age (probably due to excessive bone remodelling) and confirms the high prevalence of low bone mineral density in children with severe cerebral palsy. Possible preventive measures might include calcium + vitamin D supplementation and the systematic management of underweight and delayed puberty. Bone remodelling markers might be of value for follow-up.
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