Osteoporosis in adults with meningomyeloccle:: An unrecognized problem at rehabilitation clinics

Objectives: To assess the prevalence of osteoporosis and osteopenia in adults with meningomyelocele and to explore whether neurologic level, ambulatory status, and other medical problems are associated with bone mineral density (BMD). Design: A cross-sectional study, including a self-administered questionnaire and clinical assessment. Setting: Outpatient referral clinic in Sweden. Participants: Twenty-one adults (mean age, 30y) with meningomyelocele admitted to the Young Adult Teams in Goteborg and Boras, Sweden. Interventions: Not applicable. Main Outcome Measures: BMD in the lumbar spine and hip and forearm measured with dual x-ray absorptiometry. Results: Seven (33%) subjects had osteoporosis in at least 1 of the measured sites. Three patients had osteopenia and 2 had osteoporosis in the lumbar spine. Among the 15 subjects whose BMD of the hip region could be reliably measured, 7 (47%) had osteoporosis in the femoral neck or trochanteric region of the hip. Subjects with other medical problems commonly occurring in meningomyelocele had lower BMD in the femoral neck and trochanteric region of the hip than subjects without such factors. Ambulation alone showed only a tendency to be associated with BMD of the femoral neck, whereas the effect of other medical risk factors on BMD of the femoral neck was stronger among the nonambulators than the ambulators. Conclusions: Our results show that osteoporosis is a medical problem to be considered when treating and rehabilitating patients with meningomyelocele.