title: Importance of individual rods and plates in the assessment of bone quality and their contribution to bone stiffness.
abstract: Local morphometry based on the assessment of individual rods and plates was applied to 42 human vertebral trabecular bone samples. Results showed that multiple linear regression models based on local morphometry as a measure for bone microstructure helped improving our understanding of the role of local structural changes in the determination of bone stiffness as assessed from direct and computational biomechanics.
  
  
  BACKGROUND
  In a recent study, we proposed a method for local morphometry of trabecular bone, i.e., morphometry as applied to individual rods and plates. In this study, we used this method to study the relative importance of local morphometry in the assessment of bone architecture and its relative contribution to the stiffness of human vertebral bone.
  
  
  METHODS
  We extracted 42 human trabecular bone autopsies from nine intact spinal columns. The cylindrical samples were imaged with muCT to assess bone microstructure. From these images, global and local morphometric indices were derived and related to Young's modulus as assessed by experimental uniaxial compression testing (Emeas) and computational finite element analysis (EFE).
  
  
  RESULTS
  We found the best single predictor for Young's modulus to be apparent bone volume density (BV/TV), which explained 89% of the variance in EFE when fitted with a power law. A multiple linear regression model combining mean trabecular spacing (Tb.Sp), mean slenderness of the rods (<Ro.Sl>), and the relative amount of rod volume to total bone volume (Ro.BV/BV) was able to explain 90% of the variance in EFE. This model could not be improved by adding BV/TV as an independent variable. Furthermore, we found that mean trabecular thickness of the rods was significantly related to EFE (r2 = 0.42), whereas mean trabecular thickness of plates had no correlation to Young's modulus. Because the globally determined trabecular thickness does not discriminate between rods and plates, this index had only a poor predictive power for EFE (r2 = 0.09), showing the importance of local analysis of individual rods and plates.
  
  
  CONCLUSIONS
  From these results, we conclude that models based on local morphometry help improving our understanding of the relative importance of local structural changes in the determination of the stiffness of bone. Separate analysis of individual rods and plates may help to better predict age and disease-related fractures as well as to shed new light on the effect of pharmaceutical intervention in the prevention of such fractures beyond BMD.
authors.affiliation: Institute for Biomedical Engineering, Swiss Federal Institute of Technology (ETH) and University of Zürich, Zürich, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Stauber
authors.forename: Laurent
authors.initials: L
authors.lastname: Rapillard
authors.forename: G Harry
authors.initials: GH
authors.lastname: van Lenthe
authors.forename: Philippe
authors.initials: P
authors.lastname: Zysset
authors.forename: Ralph
authors.initials: R
authors.lastname: Müller
mesh_terms: D001696:Biomechanical Phenomena; D001842:Bone and Bones / Q000033:anatomy & histology* / Q000502:physiology*; D006801:Humans; D016268:Internal Fixators; D016014:Linear Models; D013131:Spine; D014057:Tomography, X-Ray Computed; D014129:Trabecular Meshwork