{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:03:41Z","timestamp":1787321021032,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2012,11,16]],"date-time":"2012-11-16T00:00:00Z","timestamp":1353024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:p>\n                    <jats:bold>Aim\u00a0<\/jats:bold>\n                    To assess lower extremity bone mineral density (BMD) of children with congenital spinal dysfunction and examine factors that may influence BMD in this population.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Method\u00a0<\/jats:bold>\n                    Forty\u2010four children (25 females, 19 males) aged 6 to 18\u2003years (mean 11y 11mo, SD 3y 6mo) with congenital spinal dysfunction (35 with myelomeningocele, seven with lipomas, one with sacral agenesis, one with caudal regression) were enrolled in the study. A health survey including ambulatory status, history of bladder augmentation, and history of fracture was administered. Each participant had a physical examination including Tanner stage and neurological level. Dual\u2010energy X\u2010ray absorptiometry scans of the lateral distal femur (LDF) and, when possible, lumbar spine were obtained. We reported LDF BMD results as z\u2010scores for three regions of interest (metaphyseal, metadiaphyseal, and diaphyseal). Univariable and multivariable analyses examined relationships between LDF BMD and the other variables.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results\u00a0<\/jats:bold>\n                    BMD was significantly related to ambulatory status (14 non\u2010ambulatory, 15 partly ambulatory, 15 fully ambulatory) and neurological level (13 with low\u2010level lesions, 15 medium\u2010level, 16 high\u2010level) in the univariable analysis (\n                    <jats:italic>p<\/jats:italic>\n                    &lt;0.01 for both in all three regions). Neither history of fracture, nor Tanner stage, nor history of bladder augmentation showed a significant relationship to BMD. The significance of ambulatory status and neurological level in the univariable analysis failed to persist in the multivariable analysis of this study with a small sample size.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Interpretation\u00a0<\/jats:bold>\n                    The LDF measurement proved to be a viable technique for assessing BMD in children with congenital spinal dysfunction. LDF BMD was sensitive to differences in three categories of ambulation. The overall influence of neurological level was not deemed as important as ambulation.\n                  <\/jats:p>","DOI":"10.1111\/j.1469-8749.2012.04420.x","type":"journal-article","created":{"date-parts":[[2012,11,18]],"date-time":"2012-11-18T20:27:04Z","timestamp":1353270424000},"page":"1133-1137","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Lower extremity bone mineral density in children with congenital spinal dysfunction"],"prefix":"10.1111","volume":"54","author":[{"given":"ROCHELLE E","family":"HAAS","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HEIDI H","family":"KECSKEMETHY","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MARIA A","family":"LOPICCOLO","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JOBAYER","family":"HOSSAIN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ROCHELLE T","family":"DY","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"STEVEN J","family":"BACHRACH","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,11,16]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2005.11.004"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcb.240550303"},{"key":"e_1_2_9_4_2","first-page":"130","article-title":"Osteoporosis: are there childhood antecedents for an adult health problem?","volume":"5","author":"Bailey DA","year":"1992","journal-title":"Can J Paediatr"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-70-5-1330"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(94)70193-8"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocd.2007.12.005"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002470050341"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocd.2009.01.005"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.110.1.e5"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-003-1443-y"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-003-1529-6"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2008.03102.x"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.102.3.e34"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1987.tb02508.x"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-003-1204-3"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.110.6.1193"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-010-1634-8"},{"key":"e_1_2_9_19_2","first-page":"1","volume-title":"International Standards for Neurological Classifications of Spinal Cord Injury (Revised Edition)","author":"American Spinal Injury Association","year":"2000"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/b97673"},{"key":"e_1_2_9_21_2","volume-title":"Applied Linear Statistical Models","author":"Kutner M","year":"2005"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.cnd.0000244623.06318.23"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.091007"},{"key":"e_1_2_9_24_2","first-page":"64","article-title":"Statistical validation of surrogate endpoints: is bone density a valid surrogate for fracture?","volume":"4","author":"Li Z","year":"2004","journal-title":"J Musculoskel Neuron Interact"}],"container-title":["Developmental Medicine &amp; Child Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1469-8749.2012.04420.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1469-8749.2012.04420.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T01:10:06Z","timestamp":1698714606000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1469-8749.2012.04420.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,11,16]]},"references-count":23,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2012,12]]}},"alternative-id":["10.1111\/j.1469-8749.2012.04420.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1469-8749.2012.04420.x","archive":["Portico"],"relation":{},"ISSN":["0012-1622","1469-8749"],"issn-type":[{"value":"0012-1622","type":"print"},{"value":"1469-8749","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,11,16]]},"assertion":[{"value":"2012-11-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}