Summary
Previous studies comparing axial and appendicular skeleton have shown that trabecular bone loss is greater than cortical bone loss. However, whether the same difference exists between the trabecular and the cortical compartments of the vertebral body remains to be determined. In this study, we used quantitative computer tomography (QCT) to simultaneously measure the cortical rim of the vertebral body as well as trabecular bone. In 99 Caucasian women (mean age 53.8±13.0 years, range 26–79 years) we found a significant correlation between cortical mineral content (BMCc) and both single (SE) and dual energy (DE) trabecular mineral content (BMCT) (r=0.62,P<0.0001 for both regressions). The cross-sectional rates of bone loss per year were 1.32%, 1.16%, and 0.59% for SE-BMCT, DE-BMCT, and BMCC, respectively. BMCC decreased at a rate that was 45–51% that of SE-BMCT and DE-BMCT, respectively. Our results indicate that (1) QCT may provide a useful means to selectively measure cortical density in vertebral bodies; (2) the decrease of cortical density over time in the spine appears to have been underestimated previously by extrapolation from appendicular bone measurements; (3) because measurements of the entire vertebral body (exclusive of the posterior elements) may provide information that is more representative of spine changes with age, a measurement that includes both areas might be more useful than one measuring only the trabecular region.
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References
Cameron JR, Mazess RB, Sorenson A (1968) Precision and accuracy of bone mineral determination by dual photon absorptiometry. Invest Radiol 3:141–150
Peppler WW, Mazess RB (1981) Total body bone mineral and lean body mass by dual photon absorptiometry. I. Theory and measurement procedure. Calcif Tissue Int 33:353–359
Sartoris DJ, Resnick D (1989) Dual energy radiographic absorptiometry for bone densitometry: current status and perspective. AJR 152:241–246
Pacifici R, Rupich R, Vered I, Fischer KC, Griffin M, Susman N, Avioli LV (1988) Dual energy radiography (DER): a preliminary comparative study. Calcif Tissue Int 43:189–191
Kelly TL, Slovik DM, Schoenfeld DA, Neer RM (1988) Quantitative digital radiography versus dual photon absorptiometry of the lumbar spine. J Clin Endocrinol Metab 67:839–844
Chamberlain M, Fremlin JH, Peters DK, Philip H (1968) Total body calcium by whole body neutron activation analysis: a new technique for study of bone disease. Br Med J ii:581–583
Nelp WB, Palmer HE, Murano R, Pailthorp K, Hinn GM, Rich C, Williams JL, Rudd TG, Denney JD (1970) Measurement of total body calcium (bone mass) in vivo with the use of total body neutron activation analysis. J Lab Clin Med 76:151–162
Cann CE, Genant HK (1980) Precise measurement of vertebral mineral content using computed tomography. J Comput Assist Tomogr 4:493–500
Banks LM, Stevenson JC (1986) Modified method of spinal computed tomography for trabecular bone mineral measurement. J Comput Assist Tomogr 10:463–467
Genant HK, Boyd DP (1977) Quantitative bone mineral analysis using dual-energy computed tomography. Invest Radiol 12:545–551
Rosenthal DI, Ganott MA, Wyshak G, Slovik DM, Doppelt SH, Neer RM (1985) Quantitative computed tomography for spinal density measurement: factors affecting precision. Invest Radiol 20:306–310
Riggs BL, Wahner HW, Dunn, WL, Offord KP, Melton JL (1981) Differential changes in bone mineral density of the appendicular and axial skeleton with aging. J Clin Invest 67:328–335
Nordin BEC (1971) Clinical significance and pathogenesis of osteoporosis. Br Med J 1:571–576
Genant HK, Cann CE, Ettinger B, Gordan GS (1982) Quantitative computed tomography of vertebral spongiosa: a sensitive method for detecting early bone loss after oophorectomy. Ann Intern Med 97:699–705
Richardson ML, Genant HK, Cann CE, Ettinger B, Gordon GS, Kolb FO, Reiser UJ (1985) Assessment of metabolic bone diseases by quantitative computed tomography. Clin Orthop 195:224–238
Newton-John HF, Morgan DB (1970) The loss of bone with age, osteoporosis and fractures. Clin Orthop 71:229–252
Mazess RB (1982) On aging bone loss. Clin Orthop 162:239–252
Cann CE, Genant HK, Young DR (1980) Comparison of vertebral and peripheral mineral losses in disuse osteoporosis in monkeys. Radiology 134:525–529
Meier DE, Orwoll ES, Jones JM (1984) Marked disparity between trabecular and cortical bone loss with age in men. Measurement by vertebral computed tomography and radial photon absorptiometry. Ann Int Med 101:605–612
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
Kalender WA, Felsenberg 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
Jones CD, Jeantet-Laval AM, Jeantet-Laval MH, Genant HK (1987) Importance of measurement of spongious vertebral bone mineral density in the assessment of osteoporosis. Bone 8:201–207
Ott SM, Kilcoyne RF, Chesnut III CH (1988) Comparisons among methods of measuring bone mass and relationship to severity of vertebral fractures in osteoporosis. J Clin Endocrinol Metab 66:501–507
Pacifici R, Susman N, Carr PL, Birge SJ, Aviodi LV (1987) Single and dual energy tomographic analysis of spinal trabecular bone: a comparative study in normal and osteoporotic women. J Clin Endocrinol Metab 64:209–214
Cann CE, Genant HK, Kolb FO, Ettinger B (1985) Quantitative computed tomography for prediction of vertebral fracture risk. Bone 6:1–7
Faul DD, Couch JL, Cann CE, Boyd DP, Genant HK (1982) Composition-selective reconstruction for mineral content in the axial and appendicular skeleton. J Comput Assist Tomog 6:202–208
Genant HK, Boyd DP, Rosenfeld A, Abols Y, Cann CE (1987) Computed tomography. In: Cohn SH (ed) Noninvasive measurements of bone mass and their clinical applications. CRC Press, New York, p 121
Dunnill MS, Anderson JA, Whitehead R (1967) Quantitative histological studies on age changes in bone. Pathol Bacteriol 94:275–291
Frost HM (1973) Bone remodeling and its relationship to metabolic bone disease. Charles C. Thomas, Springfield, MA
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
Nottestad SY, Baumel JJ, Kimmel DB, Recker RR, Heaney RP (1987) The proportion of trabecular bone in human vertebrae. J Bone Min Res 2:221–229
Ott SM, Kilcoyne RF, Chesnut CH (1986) Longitudinal changes in bone mass after one year as measured by different techniques in patient with osteoporosis. Calcif Tissue Int 39:133–138
Ettinger B, Genant HK, Cann CF (1987) Postmenopausal bone loss is prevented by treatment with low-dosage estrogen with calcium. Ann Int Med 106:40–45
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Pacifici, R., Rupich, R.C. & Avioli, L.V. Vertebral cortical bone mass measurement by a new quantitative computer tomography method: Correlations with vertebral trabecular bone measurements. Calcif Tissue Int 47, 215–220 (1990). https://doi.org/10.1007/BF02555922
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DOI: https://doi.org/10.1007/BF02555922