Health Sciences University, Gülhane Medical School, Department of Physical Medicine and Rehabilitation, Ankara, Turkey.
Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey.
Eur J Paediatr Neurol. 2018 Jan;22(1):17-26. doi: 10.1016/j.ejpn.2017.08.001. Epub 2017 Aug 10.
Bone modeling is a process that starts with fetal life and continues during adolescence. Complex factors such as hormones, nutritional and environmental factors affect this process. In addition to these factors, physical conditioning and medications that have toxic effects on bony tissue should be carefully considered in patient follow-up. Osteoporosis is a significant problem in pediatric population because of ongoing growth and development of skeletal system. Two types of osteoporosis are primary and secondary types and children with neuromuscular disabilities constitute a major group with secondary osteoporosis. Low bone mass in patients with cerebral palsy, spina bifida, and Duchenne muscular dystrophy cause increased bone fragility in even slight traumas. Maximizing peak bone mass and prevention of bone loss are very important to reduce the fracture risk in neuromuscular diseases. This article aims to review the determinants of bone physiology and bone loss in children with cerebral palsy, spina bifida, and Duchenne muscular dystrophy.
骨骼形成是一个始于胎儿期并在青春期持续的过程。复杂的因素，如激素、营养和环境因素，会影响这个过程。除了这些因素，在患者随访中还应仔细考虑对骨骼组织有有毒作用的身体状况和药物。由于骨骼系统的持续生长和发育，骨质疏松症在儿科人群中是一个重大问题。骨质疏松症有原发性和继发性两种类型，患有神经肌肉障碍的儿童是继发性骨质疏松症的主要群体。脑瘫、脊柱裂和杜氏肌营养不良症患者的骨量低，即使是轻微的创伤也会导致骨脆性增加。最大限度地提高峰值骨量和预防骨质流失对于降低神经肌肉疾病的骨折风险非常重要。本文旨在综述脑瘫、脊柱裂和杜氏肌营养不良症患儿的骨骼生理学和骨量流失的决定因素。
