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This study was designed to test the hypothesis that non‐ambulatory patients with spastic quadriplegia will have reduced bone mass which worsens with increasing age. Forty‐eight patients (age 5 to 48 years, median age 15 years; 19 females and 29 males) were studied. Anticonvulsants were used in 29 patients (60.4%). Lumbar spine bone mineral density (LS‐BMD) was markedly reduced compared with age‐and sex‐matched control individuals with a z score of ‐2.37±0.21. Twenty‐eight (58%) had z scores of less than ‐2. A history of documented previous fracture was present in 19 patients (39%). Patients with a history of fracture had significantly lower (p=0.05) LS‐BMD z scores (‐2.81±0.29) compared with those without a history of fracture (‐2.11±0.26). Mean serum 25‐OH vitamin D was 29.6±1.9ng/mL (normal 9 to 37.6ng/mL) with three patients having serum 25‐OH vitamin D levels less than 15ng/mL. These findings indicate that BMD is markedly reduced in non‐ambulatory children and adults with neuromuscular disease. Reductions in bone mass put them at greater risk for non‐traumatic fractures.

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