A comparison, using X-ray micro-computed tomography, of the architecture of cancellous bone from the cervical, thoracic and lumbar spine using 240 vertebral bodies from 10 body donors

Abstract

The vertebral trabecular bone has a complex three-dimensional microstructure with an inhomogeneous morphology. Correct identification and assessment of the weakest segments of the cancellous bone may lead to better prediction of fracture risk. The aim of this study was to compare cancellous bone from 240 vertebrae of the cervical, thoracic and lumbar spine of ten body donors with osteoporosis in regard to bone volume fraction (BVF), trabecular thickness, separation, trabecular number and degree of anisotropy, to ascertain why cervical vertebrae rarely fracture, even with severe osteoporosis. Samples were obtained from all vertebrae with a Jamshidi needle (8 Gauge). The investigations were performed with a micro-computed tomography (micro-CT) device (SKYSCAN 1172, RJL Micro & Analytic GmbH, Karlsdorf-Neuthard, Germany). Existing vertebral fractures and the bone mineral density of the lumbar spine were assessed with quantitative CT. Regarding the micro-CT parameters, statistically significant differences were observed between the various sections of the spine. We found a higher BVF, trabecular number and trabecular thickness, as well as a lower trabecular separation of the cervical vertebrae compared to other vertebrae. In addition, the degree of anisotropy in the cervical spine is lower than in the other spinal column sections. These results are age and sex dependent. Thus, the cervical spine has special structural features, whose causes must be determined in further investigations.

Warum sich in der Halswirbelsäule auch bei Osteoporose nur selten Insuffizienzfrakturen finden

“…Based on the results of their histomorphometric processing of the bone structure, they assume that the density of the trabecular bone in cervical vertebrae is considerably higher than that in thoracic and lumbar vertebrae. Schröder et al [24] also presented comparable results in their case report and the first pilot study [10]. Here, we detected a significant difference in the BVF in the individual spinal sections, the highest values being found for the cervical vertebrae.…”

“…Aufgrund der Ergebnisse ihrer histomorphometrischen Aufarbeitung der Knochenstruktur gehen sie davon aus, dass die Dichte des trabekulären Knochens in den Halswirbeln deutlich höher ist als im Bereich der Brust-und Lendenwirbel. Auch Schröder et al [24] gelangten in ihrem Fallbericht sowie in einer ersten Pilotstudie [10] zu vergleichbaren Ergebnissen. In der vorliegenden Untersuchung unterschied sich der Knochenvolumenanteil (BVF) in den einzelnen Wirbelsäulenabschnitten signifikant, wobei sich für die HWS die höchsten Werte ergaben.…”

“…Zur Dichte und zur Anordnung der Trabekeln der Halswirbel liegen nur wenige Daten vor [8,9,10]. Ob eine abweichende Dichte, Dicke, Anzahl, bzw.…”

“…Data on the trabeculae density and arrangement of cervical vertebrae are insufficient [8,9,10]. Deviations in the density, thickness, number and/or separation of trabeculae in the cervical vertebrae (CV) are under-researched as potential factors responsible for the low fracture tendency of the CV in patients with osteoporosis compared with those in the thoracic vertebrae (TV) and lumbar vertebrae (LV).…”

Breaking strength and bone microarchitecture in osteoporosis: a biomechanical approximation based on load tests in 104 human vertebrae from the cervical, thoracic, and lumbar spines of 13 body donors

“…Vertebral fractures (VFx) are associated with health and economic burdens, increased morbidity and mortality, and impaired quality of life [ 3 ]. In cases of significantly reduced bone density, VFx occur primarily in the thoracic, thoracolumbar and sacral areas but not in the cervical area [ 4 , 5 ]. VFx are a strong predictor of future fracture risk independent of bone mineral density (BMD) [ 6 , 7 ].…”