Related Experiment Video
Updated: Aug 9, 2026
Longitudinal Evaluation of Mouse Hind Limb Bone Loss After Spinal Cord Injury using Novel, in vivo, Methodology
Published on: December 7, 2011
Bone mineral density in children with myelomeningocele
1Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75235-9063, USA.
Insights
Patients with myelomeningocele have lower bone mineral density, increasing fracture risk. This study highlights decreased bone density and elevated urinary calcium in nonambulatory individuals, suggesting a need for targeted interventions.
Area of Science:
- Pediatric Orthopedics
- Metabolic Bone Disease
- Spinal Cord Injury Research
Background:
- Myelomeningocele often impairs ambulation, leading to physical inactivity, osteoporosis, and pathologic fractures.
- Understanding bone metabolism is crucial for managing long-term complications in affected individuals.
Purpose of the Study:
- To investigate bone mineral density (BMD) in myelomeningocele patients.
- To analyze biochemical markers of bone metabolism in this population.
Main Methods:
- 35 patients (6-19 years) with myelomeningocele were assessed.
- Bone mineral density of the distal radius was measured using single photon absorptiometry.
- Biochemical markers including parathyroid hormone, 1,25 vitamin D, osteocalcin, and urinary pyridinolines/calcium were analyzed.
Main Results:
- Patients exhibited BMD 1-2 standard deviations below the normal mean.
- Lower BMD was noted in patients with multiple fractures compared to those without.
- Elevated urinary pyridinolines (bone reabsorption) and calcium excretion were found in nonambulatory patients.
Conclusions:
- Myelomeningocele patients have reduced BMD and are at high risk for fractures.
- BMD measurement can identify patients at greatest risk.
- Increased urinary calcium excretion in nonambulators contributes to decreased BMD.
Background:
Difficulties with ambulation in patients with myelomeningocele often lead to physical inactivity, osteoporosis, and subsequent development of pathologic fractures.
Objective:
The purpose of this study was to examine bone mineral density and biochemical markers of bone metabolism in patients with myelomeningocele.
Design And Methods:
A total of 35 patients between 6 and 19 years of age with myelomeningocele (ambulatory and nonambulatory) were randomly chosen at the Texas Scottish Rite Hospital for Children. We measured bone mineral density of the distal radius in these patients using single photon absorptiometry and measured the biochemical markers of bone metabolism including parathyroid hormone, 1,25 vitamin D, osteocalcin, urinary pyridinolines/deoxypyridinolines, and urinary calcium excretion.
Results:
Bone mineral density of the distal radius in the patients with myelomeningocele was approximately 1 to 2 standard deviation units below the mean of the normal population. There were no significant differences between ambulators and nonambulators. However, bone mineral density of the 8 patients who suffered multiple fractures (19) was significantly lower than that for those remaining patients without fractures. Elevated urinary pyridinoline levels, which indicate elevated bone reabsorption, were found more frequently in both non- and limited ambulators than in full-time ambulators. Urinary calcium excretion also was greater than twofold higher in nonambulatory patients versus ambulatory patients. There were no other differences in the biochemical markers of bone metabolism (osteocalcin, parathyroid hormone, 1,25 vitamin D, and urinary deoxypyridinolines) between ambulators and nonambulators. Bone mineral density rises in normal growing children 6 to 19 years of age. When the boys and girls were considered separately, bone mineral density rises with age in boys, but not in girls.
Conclusion:
Patients with myelomeningocele have decreased bone mineral density and are at risk of suffering pathologic bone fractures. The measurement of bone mineral density may help to identify those patients at greatest risk of suffering multiple fractures. The urinary calcium excretion of nonambulators was higher than that of ambulators and likely contributes to their decreased bone mineral density. Bone mineral density increases with age in boys, but not in girls.
Related Concept Videos
01:18The Bone Matrix
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:09Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...