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Journal of Child Neurology
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Evidence-Based Review of Bone Strength in Children and Youth with Cerebral Palsy

Michal Cohen, MD

Department of Pediatrics, Sackler Faculty of Medicine, Tel-Aviv University, Israel, cohenm4{at}gmail.com, Maccabi Healthcare Services, Jerusalem & Hashfela District, Israel

Eli Lahat, MD

Department of Pediatrics, Sackler Faculty of Medicine, Tel-Aviv University, Israel, Pediatric Neurology & Rehabilitation Division, Assaf Harofeh Medical Center, Zerifin, Israel

Tzvy Bistritzer, MD

Department of Pediatrics, Sackler Faculty of Medicine, Tel-Aviv University, Israel, Pediatrics B & Pediatric Endocrinology Unit, Assaf Harofeh Medical Center, Zerifin, Israel

Amir Livne, MD

Department of Pediatrics, Sackler Faculty of Medicine, Tel-Aviv University, Israel, Pediatric Neurology & Rehabilitation Division, Assaf Harofeh Medical Center, Zerifin, Israel

Eli Heyman, MD

Department of Pediatrics, Sackler Faculty of Medicine, Tel-Aviv University, Israel, Pediatric Neurology & Rehabilitation Division, Assaf Harofeh Medical Center, Zerifin, Israel

Marianna Rachmiel, MD

Department of Pediatrics, Sackler Faculty of Medicine, Tel-Aviv University, Israel, Pediatrics B & Pediatric Endocrinology Unit Assaf Harofeh Medical Center, Zerifin, Israel

Children with cerebral palsy have various risk factors for compromised bone health. Evidence concerning their bone fragility is gathering; however, there is no consensus regarding risk factors, indications for evaluation, follow-up, or treatment. We performed an evidence-based review targeted to address the following questions concerning children with cerebral palsy: Is bone strength impaired and what are the risk factors? Are these children at increased risk for bone fractures? What are the relations between bone mineral density and fracture risk? What methods can be used for bone health assessment? How can bone strength be improved? Currently, the most acceptable method for evaluating bone status in children is dual-energy x-ray absorptiometry. Evidence demonstrates reduced bone mass in children with cerebral palsy; yet, no clear association with fractures. Preventive methods are suggested.

Key Words: cerebral palsy • bone • osteopenia • osteoporosis

This version was published on August 1, 2009

Journal of Child Neurology, Vol. 24, No. 8, 959-967 (2009)
DOI: 10.1177/0883073809332401
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