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Vertebral Osteoporosis and Trabecular Bone Quality

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Abstract

Vertebral fractures due to osteoporosis commonly occur under non-traumatic loading conditions. This problem affects more than 1 in 3 women and 1 in 10 men over a lifetime. Measurement of bone mineral density (BMD) has traditionally been used as a method for diagnosis of vertebral osteoporosis. However, this method does not fully account for the influence of changes in the trabecular bone quality, such as micro-architecture, tissue properties and levels of microdamage, on the strength of the vertebra. Studies have shown that deterioration of the vertebral trabecular architecture results in a more anisotropic structure which has a greater susceptibility to fracture. Transverse trabeculae are preferentially thinned and perforated while the remaining vertical trabeculae maintain their thickness. Such a structure is likely to be more susceptible to buckling under normal compression loads and has a decreased ability to withstand unusual or off-axis loads. Changes in tissue material mechanical properties and levels of microdamage due to osteoporosis may also compromise the fracture resistance of vertebral trabecular bone. New diagnostic techniques are required which will account for the influence of these changes in bone quality. This paper reviews the influence of the trabecular architecture, tissue properties and microdamage on fracture risk for vertebral osteoporosis. The morphological characteristics of normal and osteoporotic architectures are compared and their potential influence on the strength of the vertebra is examined. The limitations of current diagnostic methods for osteoporosis are identified and areas for future research are outlined.

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Article Open access 01 July 2023

Enisa Shevroja, Jean-Yves Reginster, … Nicholas C. Harvey

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Acknowledgments

This work is funded by the Programme for Research in Third Level Institutions (PRTLI), administered by the Higher Education Authority in Ireland. The authors thank the Trinity Centre for Bioengineering for the use of μCT scanner to produce the data for the image shown in Fig. 12. The authors would also like to acknowledge Dr. Laoise Mc Namara for useful discussions on bone remodelling.

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  1. National Centre for Biomedical Engineering Science, National University of Ireland, Galway, Ireland

    P. Mc Donnell, P. E. Mc Hugh & D. O’ Mahoney

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Mc Donnell, P., Mc Hugh, P.E. & O’ Mahoney, D. Vertebral Osteoporosis and Trabecular Bone Quality. Ann Biomed Eng 35, 170–189 (2007). https://doi.org/10.1007/s10439-006-9239-9

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