Skip to main content
Log in

The assessment of vertebral bone macroarchitecture with x-ray computed tomography

  • Session VII
  • Published:
Calcified Tissue International Aims and scope Submit manuscript

Summary

On a macroscopic scale, the structural characteristics of whole bone are likely dependent on the distribution of typically applied loads to the bone surface, the full bone shape, the thickness of the cortex at the various surface positions, and the distribution of cancellous bone material. X-ray computed tomography is presently the best available method for assessing the macroarchitecture of bone in-vivo. Fine detail, three-dimensional CT methods are available to measure regional bone mineral density (rBMD) in contiguously spaced small volumes and have been applied to the assessment of macroarchitecture in vertebrae. The more detailed rBMD methods produce radiation exposures to the subject similar to lumbar radiography and substantially higher than traditional QCT.

The cancellous bone within lumbar vertebral bodies has been found in cross-sectional studies to have increased density in the inferior, posterior and lateral regions. Notably, regions with higher density at age 40 have a larger decline with age. The vertebral body cortex declines with age at a slower rate than observed for cancellous bone; however, the decline with age of cortical bone appears to vary substantially amongst subjects. The amount of cortical bone in the anterior portion of the body is less than in the lateral portion, which may explain previous discrepancies in assessing the fraction of vertebral body bone in the cortex.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Kleerekoper M, Peterson E, Nelson D, Tilley B, Phillips E, Schork MA, Kuder J (1989) Identification of women at risk for developing postmenopausal osteoporosis with vertebral fractures: role of history and single photon absorptiometry. Bone Miner 7(2):171–186

    Google Scholar 

  2. Slemenda CW, Hui SL, Longcope C, Wellman H, Johnston CC (1990) Predictors of bone mass in perimenopausal women: a prospective study of clinical data using photon absorptiometry. Ann Int Med 112(2):96–101

    Google Scholar 

  3. Hui SL, Slemenda CW, Johnston CC Jr (1989) Baseline measurement of bone mass predicts fracture in white women. Ann Int Med 1(5):355–361

    Google Scholar 

  4. Ott SM, Kilcoyne RF, Chestnut CH (1987) Ability of four different techniques of measuring bone mass to diagnose vertebral fractures in postmenopausal women. J Bone Miner Res 2(3):201–210

    Google Scholar 

  5. Kleerekoper M, Villanueva AR, Stanciu J, Rao DS, Parfitt AM (1985) The role of three-dimensional trabecular microstructure in the pathogenesis of vertebral compression fractures. Calcif Tissue Int 37:594–597

    Google Scholar 

  6. Heaney RP (1989) Osteoporotic fracture space: an hypothesis. Bone Miner 6:1–13

    Google Scholar 

  7. Flynn MJ, Nelson D, Kleerekoper M, Peterson E, Cody DD, Li J, Ciarelli J (1992) Integral and cancellous spinal bone mass in older postmenopausal women. Proc 9th Int Bone Densitometry Workshop, Traverse City, MI p 22

  8. Cann CE, Genant HK, Kolb FO, Ettinger BF (1985) Quantitative computed tomography for prediction of vertebral fracture risk. Bone 6:1–7

    Google Scholar 

  9. Kalender WA, Fclsenberg D, Louis O, Lopez P, Klotz E, Osteaux M, Fraga J (1989) Reference values for trabecular and cortical vertebral bone density in. single and dual-energy quantitative computed tomography. Eur J Radiol 9:75–80

    Google Scholar 

  10. Pacifici R, Rupich RC, Avioli LV (1990) Vertebral cortical bone mass measurement by a new quantitative computed tomography method: correlations with vertebral trabecular bone measurements. Calcif Tissue Int 47:215–220

    Google Scholar 

  11. Ruegsegger P, Durand EP, Dambacher MA (1991) Differential effects of aging and disease on trabecular and compact bone density of the radius. Bone 12:99–105

    Google Scholar 

  12. Cody DD, Flynn MJ, Vickers DS (1989) A technique for measuring regional bone mineral density (rBMD) in human lumbar vertebral bodies. Med Phys 16(5):766–772

    Google Scholar 

  13. Kleerekoper M, Parfitt AM, Ellis BI (1984) Measurement of vertebral fracture rates in osteoporosis. In: Christiansen C, Arnaud CD, Nordin BEC, Parfitt AM, Peck WA, Riggs BL (eds) Osteoporosis. Aalborg Stiftsbogtrykkeri: Copenhagen, pp 103–108

    Google Scholar 

  14. Hedlund LR, Gallagher JC (1988) Vertebral morphometry in diagnosis of spinal fractures. Bone Miner 5:59–67

    Google Scholar 

  15. Lauridsen KN, deCarvalho A, Andersen AH (1984) Degree of vertebral wedging of the dorso-lumbar spine. Acta Radiol Diag 25:29–32

    Google Scholar 

  16. Gallagher JC, Hedlund LR, Stoner S, Meeger C (1988) Vertebral morphometry: normative data. Bone Miner 4:189–196

    Google Scholar 

  17. Mosekilde L, Mosekilde L (1986) Normal vertebral body size and compressive strength: relations to age and to vertebral and iliac trabecular bone compressive strength. Bone 7:207–212

    Google Scholar 

  18. van Schaik JJP, Verbiest H, Schaik FDJ (1985) Morphometry of lower lumbar vertebrae as seen on CT scans: newly recognized characteristics. AJR 145:327–335

    Google Scholar 

  19. Sartoris DJ, Resnick D, Guerra J (1985) Vertebral venous channels: CT appearance and differential considerations. Radiology 155:745–749

    Google Scholar 

  20. Houghton VM, Williams AL (1982) Computed tomography of the spine. CV Mosley, St. Louis, MO, pp 183–185

    Google Scholar 

  21. Cody DD, Ellis BJ, Flynn MJ, Kleerekoper M (1988) Vertebral cancellous architecture seen with CT: atypical patterns in a patient population (suppl). Radiology 169P 194

    Google Scholar 

  22. Parfitt AM, Matthews CHE, Villanueva AR, Kleerekoper M, Frame B, Rao DS (1983) Relationship between surface, volume and thickness of iliac trabecular bone on aging and in osteoporosis: implications for the microanatomic and cellular mechanism of bone loss. J Clin Invest 72:1396–1409

    Google Scholar 

  23. Sandor T, Felsenberg D, Kalender WA, Brown E (1990) Regional variations in the spinal trabecular bone: single and dual energy examinations. Calcif Tissue Int 46(2):137

    Google Scholar 

  24. Nepper-Rasmussen J, Mosekilde L (1989) Local differences in mineral content in vertebral trabecular bone measured by dualenergy computed tomography. Arta Radiol 30:369–371

    Google Scholar 

  25. Flynn MJ, Dickie DL, Kleerekoper M, D'Eramo ME (1987) Patterns of regional bone mineral density in the lumbar vertebral bodies of white female volunteers (abstract published in Radiology, November 1987). 73rd RSNA Annual Meeting, November 1987

  26. Flynn MJ, Cody DD, Kleerekoper M, Ellis BI (1989) Nonuniform regional bone mineral density decline with age in the vertebrae of perimenopausal white women. Radiology 173(P)(136): 72

    Google Scholar 

  27. Nottestad SY, Baumel JJ, Kimmel DB, Recker RR, Heaney RP (1987) The proportion of trabecular bone in human vertebrae. J Bone Miner Res 2(3):221–229

    Google Scholar 

  28. International Commission on Radiation Protection Task Group on Reference Man: Report of the Task Group on Reference Man. Pergamon Press, NY, pp 62–85

  29. Johnson LS (1964) Morphologic analysis in pathology: the kinetics of disease and general biology of bone. In: Frost HM (ed) Bone biodynamics. Little, Brown, Boston, pp 543–654

    Google Scholar 

  30. Rockoff SD, Sweet E, Bleustein J (1969) The relative contribution of trabecular and cortical bone to the strength of human lumbar vertebrae. Calcif Tissue Res 3:163–175

    Google Scholar 

  31. Block JE, Smith R, Glueer CC, Steiger P, Ettinger B, Genant HK (1989) Models of spinal trabecular bone loss as determined by quantitative computed tomography. J Bone Miner Res 4(2):249–257

    Google Scholar 

  32. Keshawarz NM, Recker RR (1984) Expansion of the medullary cavity at the expense of cortex in postmenopausal osteoporosis. Metab Bone Dis Rel Res 5:223–228

    Google Scholar 

  33. Ross PD, Heilbrun LK, Wasnich RD, Davis JW, Vogel JM (1989) Perspectives: methodologic issues in evaluating risk factors for osteoporotic fracture. J Bone Miner Res 4(5):649–656

    Google Scholar 

  34. Galante J, Rostoker W, Ray RD (1970) Physical properties of trabecular bone. Calcif Tissue Res 5:236–246

    Google Scholar 

  35. Townsend PR (1975) The distribution and anisotropy of the stiffness of cancellous bone in the human patella. J Biomech 8:363–367

    Google Scholar 

  36. Behrens JC, Walker PS, Shoji H (1974) Variations in strength and structure of cancellous bone at the knee. J Biomech 7:201–207

    Google Scholar 

  37. Brown TD, Feguson AB (1980) Mechanical property distributions in the cancellous bone of the human proximal femur. ACTA Orthop Scand 51:429–437

    Google Scholar 

  38. Mosekilde Li, Mosekilde Le, Danielsen CC (1987) Biomechanical competence of vertebral trabecular bone in relation to ash density and age in normal individuals. Bone 8:79–85

    Google Scholar 

  39. Feldkamp LA, Goldstein SA, Parfitt AM, Jesion G, Kleerekoper M (1989) The direct examination of the three-dimensional bone architecture in-vitro by computed tomography. J Bone Miner Res 4:3–11

    Google Scholar 

  40. Ciarelli MJ, Goldstein SA, Kuhn JL, Cody DD, Brown EB (1991) Evaluation of orthogonal mechanical properties and density of human trabecular bone from the major metaphyseal regions with materials testing and computed tomography. J Orthop Res 9:674–682

    Google Scholar 

  41. Struhl S, Goldstein SA, Dickie DL, Flynn MJ, Matthews LS (1987) The distribution of mechanical properties of trabecular bone within vertebral bodies and iliac crests: correlation with computed tomography density. Orthop Trans 12:262

    Google Scholar 

  42. Fyhrie DP, Hollister SJ (1990) A tissue strain remodeling theory for trabecular bone using homogenization theory. Presented at the 36th meeting of the Orthopaedic Research Society, 1990

  43. Fyhrie DP, Cody DD (1991) Direct calculation of cancellous bone stiffness and stress using an element-by-element finite element method. Trans Orthop Res Soc

  44. Eriksson SAV, Isberg BO, Lindgren JU (1989) Prediction of vertebral strength by dual photon absorptiometry and quantitative computed tomography. Calcif Tissue Int 44:243–150

    Google Scholar 

  45. Lang SM, Moyle DD, Berg ER, Detorie N, Gilpin AT, Pappas NJ, Reynolds JL, Tracik M, Waldron RL (1988) Correlation of mechanical properties of vertebral trabecular bone and equivalent mineral density as measured by CT. J Bone Joint Surg 70A(10):1531–1538

    Google Scholar 

  46. McBroom RJ, Hayes WC, Edwards WT, Goldberg RP, White AA (1985) Prediction of vertebral body compressive fracture using computed tomography. J Bone Joint Surg 67A(8):1206–1213

    Google Scholar 

  47. Cody DD, Goldstein SA, Flynn MJ, Brown EB (1991) Correlations between vertebral regional bone mineral density and whole bone fracture load. Spine 16(2):146–154

    Google Scholar 

  48. Faulkner K, Cann CE, Hasegawa BH (1991) Effect of bone distribution on vertebral strength: assessment with patientspecific nonlinear finite element analysis. Radiology 179:669–674

    Google Scholar 

  49. Firooznia H, Rafii M, Golimbu C, Schwartz MS, Ort P (1986) Trabecular mineral content of the spine in women with hip fracture: CT measurement. Radiology 159:737–740

    Google Scholar 

  50. Heuck AF, Block J, Glueer CC, Steiger P, Genant HK (1989) Mild versus definite osteoporosis: comparison of bone densitometry techniques using different statistical models. J Bone Miner Res 4(6):891–900

    Google Scholar 

  51. Reinbold WD, Genant HK, Reiser UJ, Harris ST, Ettinger B (1986) Bone mineral content in early-postmenopausal and postmenopausal osteoporotic women: comparison of measurement methods. Radiology 160:469–478

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Flynn, M.J., Cody, D.D. The assessment of vertebral bone macroarchitecture with x-ray computed tomography. Calcif Tissue Int 53 (Suppl 1), S170–S175 (1993). https://doi.org/10.1007/BF01673430

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01673430

Keywords

Navigation