Underdevelopment of trabecular bone microarchitecture in the distal femur of nonambulatory children with cerebral palsy becomes more pronounced with distance from the growth plate
Underdevelopment of trabecular bone microarchitecture in the distal femur of nonambulatory children with cerebral palsy becomes more pronounced with distance from the growth plate
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DOI：
10.1007/s00198-014-2873-4
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发表时间：
2015-02-01
影响因子：
4
通讯作者：
Miller, F.
中科院分区：
文献类型：
--
作者：
Modlesky, C. M.;Whitney, D. G.;Miller, F.
我们发现，不发达的骨小梁微结构在股骨远端的脑瘫儿童（CP）谁是无法独立行走变得更加明显，增加距离生长板。这表明CP儿童骨小梁发育不全的程度比以前所了解的要大，不能独立行走的CP儿童股骨远端的骨小梁微结构严重不发达。本研究的目的是确定骨小梁微结构发育不全的水平是否与CP儿童股骨远端一致。研究了四肢瘫痪CP儿童和典型发育儿童（n = 12/组，5 - 14岁）。表观骨体积与总体积之比（appBV/TV），小梁数量（约Tb. N），小梁厚度（appTb. Th）和小梁分离在股骨远端生长板上方采集的20个磁共振图像中，估计了每一个的appTb. Sp，对于整个区域，appBV/TV、appTb. N和appTb. Th较低CP患儿的血清Tb.Sp（分别为30、21和12%）和appTb. Sp（均为0.001）均高于对照组（52%）。在CP组和对照组中，距生长板的距离与appBV/TV和appTb. N呈负相关，与appTb. Sp呈正相关（均p <0.01）。然而，CP儿童的相关性更强（r（2）= 0.87至0.92对0.36至0.65），斜率更陡（所有p <0.01）。CP儿童股骨远端干骺端骨小梁微结构发育不全与生长板的距离越远越明显。这种模式在骨小梁微结构最不发达的儿童中最为明显。
We found that the underdeveloped trabecular bone microarchitecture in the distal femur of children with cerebral palsy (CP) who are unable to ambulate independently becomes more pronounced with increased distance from the growth plate. This suggests that the degree of underdevelopment in trabecular bone in children with CP is greater than previously understood.Children with CP who are unable to ambulate independently have severely underdeveloped trabecular bone microarchitecture in the distal femur. The aim of the study was to determine if the level of underdevelopment in trabecular bone microarchitecture is consistent across the distal femur in children with CP.Children with quadriplegic CP and typically developing children were studied (n = 12/group, 5-14 years). Apparent bone volume to total volume (appBV/TV), trabecular number (appTb.N), trabecular thickness (appTb.Th), and trabecular separation (appTb.Sp) were estimated in each of 20 magnetic resonance images collected above the growth plate in the distal femur.For the total region, appBV/TV, appTb.N, and appTb.Th were lower (30, 21, and 12 %, respectively) and appTb.Sp was higher (52 %) (all p a parts per thousand currency signaEuro parts per thousand 0.001) in children with CP than in controls. Distance from the growth plate was inversely related to appBV/TV and appTb.N and was positively related to appTb.Sp at the same distance in children with CP and controls (all p < 0.01). However, the relationships were stronger (r (2) = 0.87 to 0.92 versus 0.36 to 0.65) and the slopes were steeper in children with CP (all p < 0.01). Furthermore, the steepness of the slopes in children with CP was positively related to appBV/TV, appTb.N, appTb.Th, and appTb.Sp for the total region (r (2) = 0.37 to 0.75, p < 0.05).The underdeveloped trabecular bone microarchitecture in the metaphysis of the distal femur in children with CP becomes more pronounced with greater distance from the growth plate. This pattern is most profound in children with the least developed trabecular bone microarchitecture.