{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T20:12:35Z","timestamp":1782850355586,"version":"3.54.5"},"reference-count":21,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,9,1]]},"abstract":"<jats:sec><jats:title>Background.<\/jats:title><jats:p>Difficulties with ambulation in patients with myelomeningocele often lead to physical inactivity, osteoporosis, and subsequent development of pathologic fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective.<\/jats:title><jats:p>The purpose of this study was to examine bone mineral density and biochemical markers of bone metabolism in patients with myelomeningocele.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Methods.<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Bone mineral density of the distal radius in the patients with myelomeningocele was \u223c1 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.102.3.e34","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:44:32Z","timestamp":1092440672000},"page":"e34-e34","source":"Crossref","is-referenced-by-count":52,"title":["Bone Mineral Density in Children With Myelomeningocele"],"prefix":"10.1542","volume":"102","author":[{"given":"Albert","family":"Quan","sequence":"first","affiliation":[{"name":"From the Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Adams","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics and"},{"name":"Texas Scottish Rite Hospital for Children, Dallas, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Ekmark","sequence":"additional","affiliation":[{"name":"Texas Scottish Rite Hospital for Children, Dallas, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Baum","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics and"},{"name":"Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1998,9,1]]},"reference":[{"key":"2021121009343097300_B1","doi-asserted-by":"crossref","first-page":"883","DOI":"10.3109\/17453677408989699","article-title":"Fractures in children with myelomeningocele.","volume":"45","author":"Quilis","year":"1974","journal-title":"Acta Orthop Scand."},{"key":"2021121009343097300_B2","first-page":"211","article-title":"Fractures of the lower extremities in paraplegic children.","volume":"77","author":"Drennan","year":"1971","journal-title":"Clin Orthop."},{"key":"2021121009343097300_B3"},{"key":"2021121009343097300_B4","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/j.1469-8749.1970.tb03009.x","article-title":"Fractures of the lower limbs in spina bifida cystica: a survey of 44 fractures in 122 children.","volume":"12(suppl 22)","author":"James","year":"1970","journal-title":"Dev Med Child Neurol."},{"key":"2021121009343097300_B5"},{"key":"2021121009343097300_B6","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/01241398-198401000-00006","article-title":"Physeal, metaphyseal, and dia-physeal injuries of the lower extremities in children with myelomeningocele.","volume":"4","author":"Kumar","year":"1984","journal-title":"J Pediat Orthop."},{"key":"2021121009343097300_B7","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1111\/j.1469-8749.1987.tb02508.x","article-title":"Bone density in myelomeningocele: the effects of ambulatory status and other factors.","volume":"29","author":"Rosenstein","year":"1987","journal-title":"Dev Med Child Neurol."},{"key":"2021121009343097300_B8","doi-asserted-by":"crossref","first-page":"137","DOI":"10.2106\/00004623-197355010-00014","article-title":"Functional ambulation in patients with myelomeningocele.","volume":"55-A","author":"Hoffer","year":"1973","journal-title":"J Bone Joint Surg."},{"key":"2021121009343097300_B9","first-page":"77","article-title":"Growth of bone in school children: comparison of radiographic morphometry and photon absorptiometry.","volume":"36","author":"Mazess","year":"1972","journal-title":"Growth."},{"key":"2021121009343097300_B10"},{"key":"2021121009343097300_B11"},{"key":"2021121009343097300_B12"},{"key":"2021121009343097300_B13","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/S0140-6736(74)92606-3","article-title":"Effect of early surgery for spina bifida cystica on survival and quality of life.","volume":"1","author":"Laurence","year":"1974","journal-title":"Lancet."},{"key":"2021121009343097300_B14","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1016\/S0140-6736(66)90184-X","article-title":"Myelomeningocele and hydrocephalus, the impact of modern treatment.","volume":"1","author":"Eckstein","year":"1966","journal-title":"Lancet."},{"key":"2021121009343097300_B15","first-page":"569","article-title":"Bone mineral status in childhood accidental fractures.","volume":"138","author":"Chan","year":"1984","journal-title":"Am J Disease Child."},{"key":"2021121009343097300_B16","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1002\/jor.1100020403","article-title":"Bone density in osteopenic women: a modified distal radius density measurement procedure to develop an \u201cat risk\u201d value for use in screening women.","volume":"2","author":"Gruff","year":"1984","journal-title":"J Orthop Res."},{"key":"2021121009343097300_B17","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1111\/j.1469-8749.1996.tb15112.x","article-title":"Bone mineralization in the affected extremities of children with spastic hemiplegia.","volume":"38","author":"Lin","year":"1996","journal-title":"Dev Med Child Neurol."},{"key":"2021121009343097300_B18","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.2106\/00004623-199511000-00005","article-title":"Bone mineral density in children and adolescents who have spastic cerebral palsy.","volume":"77","author":"Henderson","year":"1995","journal-title":"J Bone Joint Surg."},{"key":"2021121009343097300_B19","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/BF01621873","article-title":"Biochemical marker of bone turnover for the clinical investigation of osteoporosis.","volume":"1(suppl 3)","author":"Delmas","year":"1993","journal-title":"Osteoperos Int."},{"key":"2021121009343097300_B20"},{"key":"2021121009343097300_B21","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1136\/adc.71.3.235","article-title":"Osteopenia in cerebral palsy.","volume":"71","author":"Shaw","year":"1994","journal-title":"Arch Dis Child."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/102\/3\/e34\/886693\/e34.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/102\/3\/e34\/886693\/e34.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,14]],"date-time":"2024-01-14T05:05:13Z","timestamp":1705208713000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/102\/3\/e34\/65959\/Bone-Mineral-Density-in-Children-With"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,9,1]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[1998,9,1]]},"published-print":{"date-parts":[[1998,9,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.102.3.e34","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[1998,9,1]]}}}