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Does thoracic or lumbar spine bone architecture predict vertebral failure strength more accurately than density?

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Abstract

Summary

Trabecular bone microstructure was studied in 6 mm bone biopsies taken from the 10th thoracic and 2nd lumbar vertebra of 165 human donors and shown to not differ significantly between these sites. Microstructural parameters at the locations examined provided only marginal additional information to quantitative computed tomography in predicting experimental failure strength.

Introduction

It is unknown whether trabecular microstructure differs between thoracic and lumbar vertebrae and whether it adds significant information in predicting the mechanical strength of vertebrae in combination with QCT-based bone density.

Methods

Six mm cylindrical biopsies taken at mid-vertebral level, anterior to the center of the thoracic vertebra (T) 10 and the lumbar vertebra (L) 2 were studied with micro-computed tomography (μCT) in 165 donors (age 52 to 99 years). The segment T11-L1 was examined with QCT and tested to failure using a testing machine.

Results

The correlation of microstructural properties was moderate between T10 and L2 (r ≤ 0.5). No significant differences were observed in the microstructural properties between the thoracic and lumbar spine, nor were sex differences at T10 or L2 observed. Cortical/subcortical density of T12 (r 2 = 48%) was more strongly correlated with vertebral failure stress than trabecular density (r 2 = 32%). BV/TV (of T10) improved the prediction by 52% (adjusted r 2) in a multiple regression model.

Conclusion

Microstructural properties of trabecular bone biopsies displayed a high degree of heterogeneity between vertebrae but did not differ significantly between the thoracic and lumbar spine. At the locations examined, bone microstructure only marginally improved the prediction of structural vertebral strength beyond QCT-based bone density.

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Acknowledgments

We would like to thank Volker Kuhn, Department of Gynecology I & Musculoskeletal Research Group, Institute of Anatomy, Ludwig-Maximilians-Universität München, Germany for his help with the μCT scans and the mechanical testing, and Mathias Priemel, Dept. of Trauma Surgery, Hamburg University School of Medicine, Hamburg, Germany, for performing the histological examinations of the iliac crest specimens. Gudrun Goldmann is to be acknowledged for her help with radiography and in preparing the iliac crest specimens for histological examination.

Funding

This work has been supported by a grant from the German Research Society (Deutsche Forschungsgemeinschaft; DFG LO 730/3-1).

Author information

Authors and Affiliations

  1. Department of Gynecology I, LMU Munich, Munich, Germany

    E.-M. Lochmüller, K. Pöschl, L. Würstlin & M. Matsuura

  2. Musculoskeletal Research Group, Institute of Anatomy, Ludwig-Maximilians-Universität Munich, Munich, Germany

    K. Pöschl, L. Würstlin & M. Matsuura

  3. Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland

    R. Müller

  4. Department of Radiology, University of California, San Francisco, CA, USA

    T. M. Link

  5. Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University (PMU) Salzburg, Strubergasse 21, A 5020, Salzburg, Austria

    F. Eckstein

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  1. E.-M. Lochmüller
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  2. K. Pöschl
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  3. L. Würstlin
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  4. M. Matsuura
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  5. R. Müller
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  6. T. M. Link
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  7. F. Eckstein
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Correspondence to F. Eckstein.

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Lochmüller, EM., Pöschl, K., Würstlin, L. et al. Does thoracic or lumbar spine bone architecture predict vertebral failure strength more accurately than density?. Osteoporos Int 19, 537–545 (2008). https://doi.org/10.1007/s00198-007-0478-x

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  • DOI: https://doi.org/10.1007/s00198-007-0478-x

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