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The relationship between bone strain index, bone mass, microarchitecture and mechanical behavior in human vertebrae: an ex vivo study

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Abstract

Summary

The aim of this study was to determine whether the Bone Strain Index (BSI), a recent DXA-based bone index, is related to bone mechanical behavior, microarchitecture and finally, to determine whether BSI improves the prediction of bone strength and the predictive role of BMD in clinical practice.

Purpose

Bone Strain Index (BSI) is a new DXA-based bone index that represents the finite element analysis of the bone deformation under load. The current study aimed to assess whether the BSI is associated with 3D microarchitecture and the mechanical behavior of human lumbar vertebrae.

Methods

Lumbar vertebrae (L3) were harvested fresh from 31 human donors. The anteroposterior BMC (g) and aBMD (g/cm2) of the vertebral body were measured using DXA, and then the BSI was automatically derived. The trabecular bone volume (Tb.BV/TV), trabecular thickness (Tb.Th), degree of anisotropy (DA), and structure model index (SMI) were measured using µCT with a 35-µm isotropic voxel size. Quasi-static uniaxial compressive testing was performed on L3 vertebral bodies under displacement control to assess failure load and stiffness.

Results

The BSI was significantly correlated with failure load and stiffness (r = -0.60 and -0.59; p < 0.0001), aBMD and BMC (r = -0.93 and -0.86; p < 0.0001); Tb.BV/TV and SMI (r = -0.58 and 0.51; p = 0.001 and 0.004 respectively). After adjustment for aBMD, the association between BSI and stiffness, BSI and SMI remained significant (r = -0.51; p = 0.004 and r = -0.39; p = 0.03 respectively, partial correlations) and the relation between BSI and failure load was close to significance (r = -0.35; p = 0.06).

Conclusion

The BSI was significantly correlated with the microarchitecture and mechanical behavior of L3 vertebrae, and these associations remained statistically significant regardless of aBMD.

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Authors and Affiliations

  1. Univ Lyon, INSERM, UMR 1033, 69008, Lyon, France

    Jean-Paul Roux, François Duboeuf, Elisabeth Sornay-Rendu, Julien Wegrzyn & Roland Chapurlat

  2. Department of Orthopedic Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland

    Julien Wegrzyn

  3. Casa Di Cura La Madonnina, Milan, Italy

    Fabio Massimo Ulivieri

  4. Tecnologie Avanzate TA Srl, Turin, Italy

    Luca Rinaudo

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  1. Jean-Paul Roux
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Correspondence to Jean-Paul Roux.

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Conflict of interest

JP Roux, F. Duboeuf, E. Sornay-Rendu, J. Wegrzyn and R. Chapurlat declare they have no conflict of interest. Luca Rinaudo is Technical manager in Tecnologie Avanzate TA s.r.l. Bone Strain Index Project and Fabio Massimo Ulivieri is Scientific coordinator in Tecnologie Avanzate TA s.r.l. Bone Strain Index Project.

Disclosures

J.P. Roux: Research grant paid to the research institution UCB. R. Chapurlat: research grants UCB and Amgen, consulting UCB, Amgen, Mereo, Amolyt. F. Duboeuf, E. Sornay-Rendu, L. Rinaudo, F.M. Ulivieri and J. Wegrzyn declare they have no disclosure.

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Roux, JP., Duboeuf, F., Sornay-Rendu, E. et al. The relationship between bone strain index, bone mass, microarchitecture and mechanical behavior in human vertebrae: an ex vivo study. Osteoporos Int (2024). https://doi.org/10.1007/s00198-024-07066-9

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