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


BACKGROUND
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 (microCT) 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 <or= 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 (r(2)=48%) was more strongly correlated with vertebral failure stress than trabecular density (r(2)=32%). BV/TV (of T10) improved the prediction by 52% (adjusted r(2)) in a multiple regression model.


CONCLUSIONS
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.
Lochmüller
E-M
EM
Department of Gynecology I, LMU Munich, Munich, Germany.
Pöschl
K
K
Würstlin
L
L
Matsuura
M
M
Müller
R
R
Link
T M
TM
Eckstein
F
F
D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology*; D002102:Cadaver; D015331:Cohort Studies; D019245:Compressive Strength; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000033:anatomy & histology / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests; D013314:Stress, Mechanical; D013904:Thoracic Vertebrae / Q000033:anatomy & histology / Q000502:physiology*; D014057:Tomography, X-Ray Computed / Q000379:methods