Vertebral morphology in healthy children

  • Research type

    Research Study

  • Full title

    Developing normative standards for vertebral morphology in children: A feasibility study

  • IRAS ID

    315446

  • Contact name

    Amaka C Offiah

  • Contact email

    amaka.offiah@nhs.net

  • Sponsor organisation

    Sheffield Children's NHS Foundation Trust

  • Clinicaltrials.gov Identifier

    NIHR200725, National Institute for Health Research

  • Duration of Study in the UK

    1 years, 2 months, 30 days

  • Research summary

    Our long-term goal is to improve the diagnosis and treatment of childhood osteoporosis by improving the detection of vertebral fractures (VF). To achieve this, we must understand the natural variation in shape and height of vertebral bodies that occurs in healthy growing children.

    Osteoporosis is thinning of the bones. There are over 25 inherited and acquired disorders (e.g. osteogenesis imperfecta, Duchenne muscular dystrophy) and well over 20 drugs (e.g. steroids, anti-cancer drugs, anticonvulsants) associated with childhood osteoporosis, all predisposing affected children to VF, significant pain and deformity. Furthermore, 40% of an adult’s total bone mass accumulates during adolescence, therefore an adolescent with osteoporosis, if untreated, is likely to become an adult with osteoporosis. Early detection and treatment are important to prevent fracture and deformity progression.

    Dual energy x-ray absorptiometry (DXA, pronounced “dexa”), which measures bone mineral density (BMD), cannot reliably predict childhood fractures, because not all children with low BMD will fracture, while some will fracture even with normal BMD. Therefore, the International Society for Clinical Densitometry has defined childhood osteoporosis based on the presence of fractures rather than on BMD. This highlights the importance of identifying VF in children.

    Taking advantage of the high-quality spine imaging at low-radiation dose of current DXA machines, we will document the normal variation in vertebral shape that occurs in healthy children, with the goal of improving VF detection and therefore improving diagnosis and treatment of childhood osteoporosis.

    This current feasibility study will recruit 70 children, from schools in Sheffield and Birmingham. Children will attend Sheffield Children’s and Birmingham Hospitals for their DXA scans.

  • REC name

    East of England - Cambridge East Research Ethics Committee

  • REC reference

    23/EE/0043

  • Date of REC Opinion

    24 Mar 2023

  • REC opinion

    Further Information Favourable Opinion