Bone mineral density in children with cerebral palsy and Spina Bifida treated with ibandronate

Background. Bisphosphonates have become a common method for the prevention and treatment of osteoporosis in children with neuromuscular diseases. Aim. The aim of this study was to assess the mid-term changes of bone mineral density in patients with cerebral palsy and spina bifida treated with ibandronic acid. Materials and methods. Thirty-four patients were examined and treated: 19 children with cerebral palsy (GMFCS levels IIIIV) and 15 children with spina bifida (thoracic and upper lumbar neurosegmental levels), mean age 9.8 2.9 years. Ibandronic acid was administered to all patients (3 consecutive intravenous infusions, 0.1 mg/kg every 34 months). The assessment of bone mineral density was performed using dual-energy X-ray absorptiometry. Results. The Z-score increased from 2.55 to 2.1 (total body less head), and from 2.7 to 1.65 (lumbar spine). Improvement of the Z-score for the lumbar spine was noted after the first infusion, and for the whole body after the first two infusions. Conclusion. Ibandronic acid infusions improved the bone mineral density in children with cerebral palsy and spina bifida for both the whole body and the lumbar spine. Given the data obtained, weight-bearing exercises can be recommended three months after the first infusion, and dynamic exercises can be performed, preferably after six months.