title: Osteoporosis changes the amount of vertebral trabecular bone at risk of fracture but not the vertebral load distribution.
abstract: METHODS
  A finite-element study to investigate the amount of trabecular bone at risk of fracture and the distribution of load between trabecular core and cortical shell, for healthy, osteopenic, and osteoporotic vertebrae.
  
  
  OBJECTIVE
  To determine differences between healthy, osteopenic, and osteoporotic vertebrae with regard to the risk of fracture and the load distribution.
  
  
  BACKGROUND
  The literature contains no reports on the effects of osteopenia and osteoporosis on load distribution in vertebral bodies, nor any reports on the amount of trabecular bone at risk of fracture.
  
  
  METHODS
  Computed tomography data of vertebral bodies were used to construct patient-specific finite-element models. These models were then used in finite-element analyses to determine the physiologic stresses and strains in the vertebrae.
  
  
  RESULTS
  For all three classes of vertebrae the contribution of the trabecular core to the total load transfer decreased from about 70% near the endplates to about 50% in the midtransverse region. The amount of trabecular bone that is at risk of fracture was about 1% for healthy vertebrae, about 3% for osteopenic vertebrae, and about 16% for osteoporotic vertebrae.
  
  
  CONCLUSIONS
  Our finite-element models indicated that neither osteopenia nor osteoporosis had any effect on the contribution of the trabecular core to the total load placed on the vertebra. The trabecular core carried about half the load. Our finite-element models indicated that osteoporosis had a significant effect on the amount of trabecular bone at risk of fracture, which increased from about 1% in healthy vertebrae to about 16% for osteoporotic vertebrae.
authors.affiliation: Orthopedic Research Lab, University of Nijmegen, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Homminga
authors.forename: H
authors.initials: H
authors.lastname: Weinans
authors.forename: W
authors.initials: W
authors.lastname: Gowin
authors.forename: D
authors.initials: D
authors.lastname: Felsenberg
authors.forename: R
authors.initials: R
authors.lastname: Huiskes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019245:Compressive Strength / Q000502:physiology*; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011859:Radiography; D016103:Spinal Fractures / Q000209:etiology / Q000503:physiopathology*; D016474:Weight-Bearing / Q000502:physiology