Low bone mineral density and fractures are highly prevalent in pediatric patients with spinal muscular atrophy regardless of disease severity

Highlights • Low BMD was highly prevalent in SMA patients, regardless of SMA subtype. • Lateral distal femur BMD declined over time for all SMA subtypes. • All SMA subtypes had high fracture frequency with predominance of femur fractures. • Time to first fracture was not different among SMA subtypes, although SMA1 patients tended to be younger. • Despite fractures and low BMD, few SMA patients met the criteria for osteoporosis.