Analysis of Bone Mineral Density and Body Composition in Lower and Upper Limbs of Spina Bifida Patients Using DXA Scans.

OBJECTIVES

Several tools are available for the assessment and classification of lesion level in spina bifida (SB) patients. This study aimed to quantitatively investigate potential relationships that lesion level and mobility style may have with bone mineral density (BMD) and body composition in both lower and upper limbs using dual-energy X-ray absorptiometry (DXA) scans in patients with SB.

METHODS

We investigated 74 patients (34 boys, 40 girls) with SB (mean age 12.8 years, range 10-18 years) using DXA scans to analyze BMD and body composition. Participants were classified by lesion level (upper lumbar or above, mid lumbar, lower lumbar, and sacral) for analysis of lower and upper limbs. Patients were reclassified by functional mobility scale (FMS) 50-m rating (wheelchair users, assisted ambulators, and independent ambulators) for further analysis of upper limbs.

RESULTS

The abovementioned lesion level groups contained 18, 17, 20, and 19 patients, respectively. A one-way analysis of variance (ANOVA) of lower limb outcomes showed significant intragroup homogeneity for BMD and body composition and also revealed a stepwise pattern that was consistent across multiple analyses. The FMS-based upper limb groups contained 19, 15, and 40 patients, respectively. Our analysis of BMD and percent bone mineral content did not reveal statistically significant trends in the upper limbs.

CONCLUSIONS

Lower limb body composition among children with SB was significantly classified by lesion level using ANOVA. In the upper limbs, our results showed no significant correlation between lesion level and BMD or body composition.