Bone mineral density in children with cerebral palsy and Spina Bifida treated with ibandronate

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

Background. Bisphosphonates have become a common method for the prevention and treatment of osteoporosis in children with neuromuscular diseases. Aim. The aim of this study was to assess the mid-term changes of bone mineral density in patients with cerebral palsy and spina bifida treated with ibandronic acid. Materials and methods. Thirty-four patients were examined and treated: 19 children with cerebral palsy (GMFCS levels III–IV) and 15 children with spina bifida (thoracic and upper lumbar neurosegmental levels), mean age 9.8 ± 2.9 years. Ibandronic acid was administered to all patients (3 consecutive intravenous infusions, 0.1 mg/kg every 3–4 months). The assessment of bone mineral density was performed using dual-energy X-ray absorptiometry. Results. The Z-score increased from –2.55 to –2.1 (total body less head), and from –2.7 to –1.65 (lumbar spine). Improvement of the Z-score for the lumbar spine was noted after the first infusion, and for the whole body after the first two infusions. Conclusion. Ibandronic acid infusions improved the bone mineral density in children with cerebral palsy and spina bifida for both the whole body and the lumbar spine. Given the data obtained, weight-bearing exercises can be recommended three months after the first infusion, and dynamic exercises can be performed, preferably after six months.

Full Text

Restricted Access

About the authors

Vladimir M. Kenis

The Turner Scientific Research Institute for Children’s Orthopedics

Email: kenis@mail.ru
MD, PhD, D.Sc., Professor, Deputy Director of Development and International Relations, Head of the Department of Foot Pathology, Neuroorthopedics and Systemic Diseases 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Andrei V. Sapogovskiy

The Turner Scientific Research Institute for Children’s Orthopedics

Email: sapogovskiy@gmail.com
MD, PhD, Research Associate of the Department of Foot Pathology, Neuroorthopedics and Systemic Diseases 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Tatyana N. Prokopenko

The Turner Scientific Research Institute for Children’s Orthopedics

Email: prokopenkotn@mail.ru
MD, Pediatrician of the Consultative and Diagnostic Center 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Artur N. Bergaliev

The Turner Scientific Research Institute for Children’s Orthopedics

Email: bergaliev2006@mail.ru
MD, PhD, D.Sc., Radiologist 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Stanislav V. Ivanov

The Turner Scientific Research Institute for Children’s Orthopedics

Email: ortostas@mail.ru
MD, PhD, Head of the Department of Cerebral Palsy and the Spina Bifida Сenter 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Tatyana I. Kiseleva

The Turner Scientific Research Institute for Children’s Orthopedics

Email: orthokis@mail.ru
MD, Orthopedic and Trauma Surgeon of the Department of Foot and Ankle Surgery, Neuroorthopedics and Skeletal Dysplasias 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Yuriy Alekseevich Lapkin

Email: lapkin1950@mail.ru

Nadezhda Yur'evna Krutikova

Email: krutnad@mail.ru

Vadim Gennadievich Arsent'ev

Email: rainman63@mail.ru

References

  1. Yaşar E, Adigüzel E, Arslan M, Matthews DJ. Basics of bone metabolism and osteoporosis in common pediatric neuromuscular disabilities. Eur J Paediatr Neurol. 2018;22(1):17-26. https://doi.org/10.1016/ j.ejpn.2017.08.001.
  2. Кенис В.М., Богданова С.Л., Прокопенко Т.Н., и др. Биомаркеры метаболизма костной ткани у детей с церебральным параличом, способных к передвижению // Ортопедия, травматология и восстановительная хирургия детского возраста. – 2019. – Т. 7. – № 4. – С. 79–86. [Kenis VM, Bogdanova SL, Prokopenko TN. Bone metabolism biomarkers in walking children with cerebral palsy. Pediatric traumatology, orthopaedics and reconstructive surgery. 2019;7(4):79-86. (In Russ.)]. https://doi.org/10.17816/PTORS7479-86.
  3. Houlihan CM, Stevenson RD. Bone density in cerebral palsy. Phys Med Rehabil Clin N Am. 2009;20(3):493-508. https://doi.org/10.1016/j.pmr.2009.04.004.
  4. Moon SJ, An YM, Kim SK, et al. The effect of low-dose intravenous bisphosphonate treatment on osteoporosis in children with quadriplegic cerebral palsy. Korean J Pediatr. 2017;60(12):403-407. https://doi.org/10.3345/kjp.2017.60.12.403.
  5. Иванов С.В., Кенис В.М., Прокопенко Т.Н., и др. Переломы нижних конечностей у детей с последствиями спинномозговых грыж // Ортопедия, травматология и восстановительная хирургия детского возраста. – 2018. – Т. 6. – № 3. – С. 25–31. [Ivanov SV, Kenis VM, Prokopenko TN, et al. Fractures of lower limbs in children with spina bifida. Pediatric traumatology, orthopaedics and reconstructive surgery. 2018;6(3):25-31. (In Russ.)]. https://doi.org/10.17816/PTORS6325-31.
  6. Bass SL, Naughton G, Saxon L, et al. Exercise and calcium combined results in a greater osteogenic effect than either factor alone: a blinded randomized placebo-controlled trial in boys. J Bone Miner Res. 2007;22(3):458-464. https://doi.org/10.1359/jbmr.061201.
  7. Kilpinen-Loisa P, Nenonen H, Pihko H, Makitie O. High-dose vitamin D supplementation in children with cerebral palsy or neuromuscular disorder. Neuropediatrics. 2007;38(4):167-172. https://doi.org/10.1055/s-2007-990266.
  8. Kim MJ, Kim SN, Lee IS, et al. Effects of bisphosphonates to treat osteoporosis in children with cerebral palsy: a meta-analysis. J Pediatr Endocrinol Metab. 2015;28(11-12):1343-1350. https://doi.org/10.1515/jpem-2014-0527.
  9. Fehlings D, Switzer L, Agarwal P, et al. Informing evidence-based clinical practice guidelines for children with cerebral palsy at risk of osteoporosis: a systematic review. Dev Med Child Neurol. 2012;54(2):106-116. https://doi.org/10.1111/j.1469-8749.2011.04091.x.
  10. Marreiros HF, Loff C, Calado E. Osteoporosis in paediatric patients with spina bifida. J Spinal Cord Med. 2012;35(1):9-21. https://doi.org/10.1179/2045772311Y.0000000042.
  11. Lewiecki EM, Gordon CM, Baim S, et al. Special report on the 2007 adult and pediatric Position Development Conferences of the International Society for Clinical Densitometry. Osteoporos Int. 2008;19(10):1369-1378. https://doi.org/10.1007/s00198-008-0689-9.
  12. Кенис В.М., Иванов С.В., Киселева Т.И., и др. Переносимость и безопасность применения бисфосфонатов у детей с детским церебральным параличом // Детская и подростковая реабилитация. – 2018. – № 3. – С. 28–33. [Kenis VM, Ivanov SV, Kiseleva TI, et al. Tolerability and safety of bisphosphonates in children with cerebral palsy. Detskaya i podrostkovaya reabilitatsiya. 2018;(3):28-33. (In Russ.)]
  13. Henderson RC, Lark RK, Kecskemethy HH, et al. Bisphosphonates to treat osteopenia in children with quadriplegic cerebral palsy: a randomized, placebo-controlled clinical trial. J Pediatr. 2002;141(5):644-651. https://doi.org/10.1067/mpd.2002.128207.
  14. Bachrach SJ, Kecskemethy HH, Harcke HT, et al. Pamidronate treatment and posttreatment bone density in children with spastic quadriplegic cerebral palsy. J Clin Densitom. 2006;9(2):167-174. https://doi.org/10.1016/ j.jocd.2005.11.003.
  15. Plotkin H, Coughlin S, Kreikemeier R, et al. Low doses of pamidronate to treat osteopenia in children with severe cerebral palsy: a pilot study. Dev Med Child Neurol. 2006;48(9):709-712. https://doi.org/10.1017/S0012162206001526.
  16. Paksu MS, Vurucu S, Karaoglu A, et al. Osteopenia in children with cerebral palsy can be treated with oral alendronate. Childs Nerv Syst. 2012;28(2):283-286. https://doi.org/10.1007/s00381-011-1576-9.
  17. Damilakis J. et al. Pediatric radiation dose and risk from bone density measurements using a GE Lunar Prodigy scanner. Osteoporos Int. 2013;24(7):2025-2031. https://doi.org/10.1007/s00198-012-2261-x.

Statistics

Views

Abstract: 46

PlumX


Copyright (c) 2020 Kenis V.M., Sapogovskiy A.V., Prokopenko T.N., Bergaliev A.N., Ivanov S.V., Kiseleva T.I., Lapkin Y.A., Krutikova N.Y., Arsent'ev V.G.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies