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Role of trabecular morphology in the etiology of age-related vertebral fractures

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Summary

Osteoporotic compression fractures of the spine differ from most other age-related fractures in that they usually are associated with minimal trauma and with loads no greater than those encountered during normal activities of daily living. With aging and osteoporosis, there is progressive resorption of bone, resulting in reductions in bone density, thinning of trabeculae, and loss of trabecular contiguity. These changes in trabecular bone structure are associated with losses in bone strength which are disproportionate to the reductions in bone mass alone. To explain this disproportionate loss of bone strength, the prevailing opinion is that density reductions in the vertebral centrum are accompanied by a reduction in the number of trabeculae, by preferential resorption of horizontal trabeculae, and by hypertrophy of the remaining vertical trabeculae. To evaluate this view of vertebral morphology, we performed three-dimensional stereological analysis of trabecular bone extracted from midsagittal sections of first lumbar vertebral bodies from 12 donors spanning an age of 27–81 years. We found that both the number (R2 = 0.63,P < 0.01) and thickness (R2 = 0.91,P < 0.01) of trabeculae decreased linearly with density (as expressed by bone volume fraction) whereas the spacing between the trabeculae (R2 = 0.61,P < 0.01) increased reciprocally. There were more vertical trabeculae with transverse trabeculae at all densities, and the number of vertical trabeculae changed with density at twice the rate of the number of transverse trabeculae (P < 0.001). These data do not support the prevailing view that there is preferential resorption of horizontal trabeculae or hypertrophy of the remaining vertical trabeculae. Bone density was also a strong (R2 = 0.90,P < 0.01) power law function of the ratio of trabecular thickness to mean intertrabecular spacing. From buckling theory, the critical buckling load of a trabecula is related to this ratio of trabecular thickness to effective length. The changes in trabecular morphology observed with decreasing bone density thus pose a “triple threat” to the strength and stability of vertebral trabecular bone, as not only are there fewer trabeculae, but the remaining trabeculae are both thinner and longer.

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References

  1. Melton LJ, Kan SH, Frye MA, Wahner HW, O'Fallen WM, Riggs BL (1989) Epidemiology of vertebral fractures in women. Am J Epidemiol 129:1000–1011

    Google Scholar 

  2. Hansson T, Roos B, Nachemson A (1980) The bone mineral content and ultimate compressive strength of lumbar vertebrae. Spine 5:46–54

    Google Scholar 

  3. McBroom RJ, Hayes WC, Edwards WT, Goldberg RP, White AA (1985) Prediction of vertebral body compressive fracture using quantitative computed tomography. J Bone Joint Surg [Am] 67:1206–1214

    Google Scholar 

  4. Mosekilde L, Mosekilde L (1986) Normal vertebral body size and compressive strength: relations to age and to vertebral and iliac trabecular bone compressive strength. Bone 7:207–212

    Google Scholar 

  5. Hansson T, Roos B (1981) The relation between bone mineral content, experimental compression fractures, and disc degeneration in lumbar vertebrae. Spine 6:147–153

    Google Scholar 

  6. Mosekilde L (1988) Age-related changes in vertebral trabecular bone architecture: assessed by a new method. Bone 9:247–250

    Google Scholar 

  7. Mosekilde L (1990) Age-related loss of vertebral trabecular bone mass and structure-biomechanical consequences. In: Mow VC, Ratcliffe A, Woo SLY (eds) Biomechanics of diarthrodial joints. Springer-Verlag, New York, pp 83–96

    Google Scholar 

  8. Mosekilde L, Viidik A, Mosekilde L (1985) Correlations between the compressive strength of iliac and vertebral trabecular bone in normal individuals. Bone 6:291–295

    Google Scholar 

  9. Rho JY, Hobatho MC, Ashman RB (1992) Relationships between axial modulus, ultimate strength, density, and CT numbers for human cortical and cancellous bone. Trans 38th ORS 17:557

    Google Scholar 

  10. Biggemann M, Hilweg D, Brinckmann P (1988) Prediction of the compressive strength of vertebral bodies of the lumbar spine by quantitative computed tomography. Skeletal Radiol 17:264–269

    Google Scholar 

  11. Brinckmann P, Biggemann M, Hilweg D (1989) Prediction of the compressive strength of human lumbar vertebrae. Spine 14:606–610

    Google Scholar 

  12. Buchanan JR, Myers C, Greer RB, Lloyd T, Varano LA (1987) Assessment of the risk of vertebral fracture in menopausal women. J Bone Joint Surg [Am] 69:212–218

    Google Scholar 

  13. Dickie DL, Goldstein SA, Flynn MJ, Kleerekoper M, Matthews LS (1987) Regional vertebral bone density distribution measurements and their correlation to whole bone strength. Trans 33rd ORS 12:261

    Google Scholar 

  14. Eriksson SAV, Isberg BO, Lindgren JU (1989) Prediction of vertebral strength by dual photon absorptiometry and quantitative computed tomography. Calcif Tissue Int 44:243–250

    Google Scholar 

  15. Kaufman JJ, Hakim N, Nasser P, Mont M, Klion M, Herman G, Pilla AA, Siffert RS (1988) Digital image processing of vertebral computed tomography scans for mechanical strength estimation. Trans 34th ORS 13:230

    Google Scholar 

  16. Lang SM, Moyle DD, Berg EW, Detoria N, Gilpin AT, Pappas NJ, Reynolds JC, Tkacik M, (1988) Correlation of mechanical properties of vertebral trabecular bone with equivalent mineral density as measured by computed tomography. J Bone Joint Surg [Am] 70:1531–1538

    Google Scholar 

  17. Bohr H, Schaadt O (1983) Bone mineral content of femoral bone and the lumbar spine measured in women with fracture of the femoral neck by dual photon absorptiometry. Clin Orthop 179:240–245

    Google Scholar 

  18. Kaplan FS, Dalinka M, Karp JS, Fallon MD, Katz M, Boden S, Simpson E, Attie M (1989) Quantitative computed tomography reflects vertebral fracture morbidity in osteopenic patients. Orthopaedics 12:949–955

    Google Scholar 

  19. Ott SM, Kilcoyne RF, Chestnut CH (1987) Ability of four different techniques of measuring bone mass to diagnose vertebral fractures in postmenopausal women. J Bone Min Res 2:201–210

    Google Scholar 

  20. Reinbold WD, Genant HK, Reiser UJ, Harris ST, Ettinger B (1986) Bone mineral content in early-postmenopausal and postmenopausal osteoporosic women: comparison of measurement methods. Radiology 160:469–478

    Google Scholar 

  21. Hearney RP (1992) The natural history of vertebral osteoporosis: Is low bone mass an epiphenomenon? Bone 13:S23-S26

    Google Scholar 

  22. Mosekilde L, Mosekilde L, Danielsen CC (1987) Biomechanical competence of vertebral trabecular bone in relation to ash density and age in normal individuals. Bone 8:79–85

    Google Scholar 

  23. Parfitt AM (1987) Trabecular bone architecture in the pathogenesis and prevention of fracture. Am J Med 82:68–72

    Google Scholar 

  24. Arnold JS (1980) Trabecular pattern and shapes in aging and osteoporosis. Metab Bone Dis 2:297–308

    Google Scholar 

  25. Atkinson PJ (1967) Variation in trabecular structure of the vertebrae with age. Calcif Tissue Res 1:24–32

    Google Scholar 

  26. Casuccio C (1962) An introduction to the study of osteoporosis (biochemical and biophysical research in bone ageing). Proc Royal Society of Medicine 55:663–668

    Google Scholar 

  27. Parfitt AM (1984) Age-related structural changes in trabecular and cortical bone: cellular mechanisms and biomechanical consequences. Calcif Tissue Int 365:123–128

    Google Scholar 

  28. Saville PD (1967) A quantitative approach to simple radiographic diagnosis of osteoporosis: its application to the osteoporosis of rheumatoid arthritis. Arthritis Rheum 10:416–422

    Google Scholar 

  29. Siffert RS (1967) Trabecular patterns in bone. Am J Roentgenol 99:746–755

    Google Scholar 

  30. Steinbach HL (1964) The roentgen appearance of osteoporosis. Radiol Clin N Am 2:191–207

    Google Scholar 

  31. Bergot C, Laval-Jeantet AM, Preteux F, Meunier A (1988) Measurement of anisotropic vertebral trabecular bone loss during aging by quantitative image analysis. Calcif Tissue 43:143–149

    Google Scholar 

  32. Eder M (1960) Der strukturumbau der wirbelspongiosa. Virchows Arch Path Anat 333:509–522

    Google Scholar 

  33. Pesch HJ, Henschke F, Seibold H (1977) The influence of mechanical forces and age on the remodelling of the spongy bone in lumbar vertebrae and in the neck of the femur. A structural analysis. Virchows Arch (Pathol Anat) 377:27–42

    Google Scholar 

  34. Preteux F, Bergot C, Laval-Jeantet AM (1985) Automatic quantification of vertebral cancellous bone remodeling during aging. Anat Clin 7:203–208

    Google Scholar 

  35. Vesterby A, Gundersen HJG, Melsen F (1989) Star volume of marrow space and trabeculae of the first lumbar vertebra: sampling efficiency and biological variation. Bone 10:7–13

    Google Scholar 

  36. Bell GH, Dunbar O, Beck JS, Gibb A (1967) Variations in strength of vertebrae with age and their relation to osteoporosis. Calcif Tissue Res 1:75–86

    Google Scholar 

  37. Mosekilde L, Mosekilde L (1988) Iliac crest trabecular bone volume as predictor for vertebral compressive strength, ash density and trabecular bone volume in normal individuals. Bone 9:195–199

    Google Scholar 

  38. Carter DR, Hayes WC (1977) The compressive behavior of bone as a two-phase porous structure. J Bone Joint Surg [Am] 59:954–962

    Google Scholar 

  39. Galante J, Rostoker W, Ray RD (1970) Physical properties of trabecular bone. Calcif Tissue Res 5:236–246

    Google Scholar 

  40. Snyder BD (1991) Anisotropic structure-property relations for trabecular bone, Ph.D. Thesis. University of Pennsylvania, Philadelphia, 1991

    Google Scholar 

  41. Saltykov SA (1958) Sterometric metallography, 2nd ed. Metallurgizdat, Moscow

    Google Scholar 

  42. Fung YC (1977) A first course in continuum mechanics. Prentice-Hall, Englewood Cliffs, NJ

    Google Scholar 

  43. Crandall SH, Dahl NC, Lardner TJ (1978) An introduction to the mechanics of solids. McGraw-Hill, New York

    Google Scholar 

  44. Cruz-Drive LM (1976) Quantifying pattern: a stereological approach. J Micros 107:1–18

    Google Scholar 

  45. Harrigan TP, Mann RW (1984) Characterization of microstructural anisotropy in orthotropic materials using a second rank tensor. J Mater Science 19:761–767

    Google Scholar 

  46. Whitehouse WJ (1974) The quantitative morphology of anisotropic trabecular bone. J Microscopy 101:153–168

    Google Scholar 

  47. Dehoff RT, Rhines FN (1968) Quantitative microscopy. McGraw-Hill, New York

    Google Scholar 

  48. Parfitt A, Mathews CHE, Villanueva AR, Kleerekoper M, Frame B, Rao DS (1983) Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis. Implications for the microanatomic and cellular mechanisms of bone loss. J Clin Invest 72:1396–1409

    Google Scholar 

  49. Weibel ER (1980) Stereological methods: theoretical foundations. Academic Press, London

    Google Scholar 

  50. Weinstein RS, Hutson MS (1987) Decreased trabecular width and increased trabecular spacing contribute to bone loss with aging. Bone 8:137–142

    Google Scholar 

  51. Ashman RB, Rho JY (1988) Elastic modulus of trabecular bone material. J Biomech 21:177–181

    Google Scholar 

  52. Lindahl O (1976) Mechanical properties of dried defatted spongy bone. Acta Orthop Scand 47:11

    Google Scholar 

  53. Snyder BD, Piazza SJ, Hayes WC (1991) Mechanisms of trabecular bone failure in the osteoporotic lumbar vertebral body. Trans 37th ORS 16:132

    Google Scholar 

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Authors and Affiliations

  1. Orthopaedic Biomechanics Laboratory, Charles A. Dana Research Institute, Beth Israel Hospital, 330 Brookline Avenue, Boston, Massachusetts, 02215, USA

    B. D. Snyder, S. Piazza & W. C. Hayes

  2. Orthopaedic Research Laboratory, SUNY Health Science Center, Syracuse, New York, 13210, USA

    W. T. Edwards

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  1. B. D. Snyder
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  2. S. Piazza
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  3. W. T. Edwards
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  4. W. C. Hayes
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Snyder, B.D., Piazza, S., Edwards, W.T. et al. Role of trabecular morphology in the etiology of age-related vertebral fractures. Calcif Tissue Int 53 (Suppl 1), S14–S22 (1993). https://doi.org/10.1007/BF01673396

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