Advanced skeletal maturity in children and adolescents with myelomeningocele.
Ronald Roiz, Nicole M Mueske, Alexander Van Speybroeck and 3 others
PMID 29125519WHAT IT FOUND
Children with myelomeningocele, especially those over 8 who are overweight or in puberty, often have bone age advanced by more than a year.
This can mislead growth predictions, so checking actual bone age is vital before planning orthopedic or endocrine interventions.
Key findings
01Bone age was significantly advanced compared to chronological age in the overall group, with a median difference of 0.50 years.
02Advanced skeletal maturity was most strongly associated with higher Tanner stage (puberty) and higher weight, rather than sex or shunt status.
0380% of children over 8 who were overweight or obese and had entered puberty had bone age advanced by more than 1 year.
STILL TO COME
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What it does not show
The sample was skewed toward mid-lumbar lesions and ambulatory participants, so results may not apply to non-ambulatory children or those with higher-level lesions. Height measurements using standing or supine methods may underestimate true height in children with scoliosis or contractures, potentially affecting BMI calculations. The study had a high proportion of Hispanic participants, which may limit generalizability to other ethnic groups. The cross-sectional design cannot track individual growth trajectories over time.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume all children with myelomeningocele have advanced bone age. The median difference was only 0.50 years, and nearly half were within 1 year of their chronological age. Advanced maturity was concentrated in those over 8 who were overweight or in puberty, so applying this to younger or leaner children could lead to incorrect growth predictions.