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

Lochmüller, E.-M.<sup>1</sup>; Pöschl, K.<sup>1,2</sup>; Würstlin, L.<sup>1,2</sup>; Matsuura, M.<sup>1,2</sup>; Müller, R.<sup>3</sup>; Link, T. M.<sup>4</sup>; Eckstein, F.<sup>5</sup>

Affiliations

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

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

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

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

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

Abstract and keywords

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 (r² = 48%) was more strongly correlated with vertebral failure stress than trabecular density (r² = 32%). BV/TV (of T10) improved the prediction by 52% (adjusted r²) 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.

Keywords: Failure stress; Mechanical strength; Micro computed tomography; Quantitative computed tomography (QCT); Spine; Trabecular microstructure

Links

DOI: 10.1007/s00198-007-0478-x

PubMed: 17912574

WoS: 000253995100015

History

Received: 2007-01-23

Accepted: 2007-09-04

Online: 2007-10-03

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2020	McKay M, Jackman TM, Hussein AI, Guermazi A, Liu J, Morgan EF. Association of vertebral endplate microstructure with bone strength in men and women. Bone. February 2020;131:115147.
2011	Burghardt AJ, Link TM, Majumdar S. High-resolution computed tomography for clinical imaging of bone microarchitecture. Clin Orthop Relat Res. August 2011;469:2179-2193.