Question of the Month: Are people with Spina Bifida Occulta at an increased risk of osteoporosis?  Are calcium supplements, such Os-Cal, known or believed to be helpful for people with Spina Bifida?

We do know that both children and adults with repaired myelomeningocele have lower bone density in their lumbar spine and in their hips (greater trochanter) than the general population. This is true for both those who ambulate and those who use wheelchairs for the majority of their mobility. The decrease in bone density seems to be greater for those who do not ambulate, but may be due to other associated medical conditions rather than the lack of walking itself. The associated medical conditions that also impact bone density include kidney failure, use of anti-seizure medication, taking steroids for long periods of time, and associated genetic conditions such as Down syndrome.

There are no studies that I know of which show benefit from taking bone density medications in patients with repaired myelomeningocele. It is probably helpful to ensure adequate calcium and vitamin D intake. Adults should ingest 1500mg of calcium and 800 IU of vitamin D daily, particularly if they do not spend much time outdoors. If you are prone to kidney stones, you will want to talk with your health care provider before starting calcium or vitamin D supplements, as the risk of developing stones while on these supplements is not entirely agreed upon.

As for those with Spina Bifida occulta, there is less known. If there are no spinal cord issues, such as a tethered cord that interferes with the ability to ambulate, I don’t think the bone density of the normally developed vertebrae should be decreased. The affected vertebrae that are not fused will be recorded as having a lower density because they are incompletely developed. Thus, I would suggest studying only to the fully fused vertebrae or the hip (greater trochanter) for the official measurement. As for those with myelomeningocele, calcium and vitamin D supplements should be helpful if there is insufficient intake in the diet.

For more information on the genetics and factors associated with Spina Bifida, please visit the Spina Bifida Association fact sheet.

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