The overall goal of this dissertation was to investigate the structural consequences of trabecular damage on the mechanical behavior of the vertebral body. Two questions of particular interest were:​ (1) What is the relationship, if any, between the strain level to which whole vertebral bodies are loaded, and both the corresponding reductions in stiffness and strength, and the development of residual strains? and (2) Where in the vertebral body is damage most detrimental?

To address the first question, a series of load-reload experiments were conducted on sagittal sections of vertebral bodies (n = 19) and whole vertebral bodies (n = 26). Results demonstrated that percent reductions in structural stiffness and ultimate load can be substantial (up to 80%), and that strains typical of nonfracturing falls can lead to permanent residual strains. With regard to the second research question, it was hypothesized that damage would be more detrimental to the structural stiffness of the vertebral body if it occurred in regions of higher strain energy density. Anatomically accurate finite element models based on computed tomography scans of individual vertebral sagittal slices (n = 19) and whole vertebral bodies (n = 7) were developed which included explicit modeling of the mechanical behavior of damaged trabecular bone. Results from these analyses, when combined with experimental data, confirmed this hypothesis. They further indicated that critical locations for damage are not necessarily the locations of high or low bone density, and do not always occur in the same anatomic location across bones. The success of the finite element technique developed here for investigating damage suggests that such models can be powerful tools for further investigation into the damage behavior of bones. This in turn may lead to strategies for improving clinical assessment of fracture risk, and for optimizing surgical treatments to repair or avoid such damage.