Asymptomatic Fractures in Osteoporotic Spines of the Aged

Gershon-Cohen, J; Rechtman, Ariel; Schraer, Harald; Blumberg, Nathan

doi:10.1001/jama.1953.02940240017005

Cited by 76 publications

(15 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although much of the mortality and morbidity due to osteoporosis-related fractures are associated with those of the hip [9, 18], pain and disability associated with fracture of the spine is no less of a problem, especially when the fact that 50% of the elderly female population is expected to have at least one vertebral fracture is considered [40, 41, 46]. Thoracic 12 and lumbar 1 together have the highest incidence of vertebral collapse and account for 24.2–60.6% of all vertebral fractures among T3 to L5 levels [2, 4, 16, 19, 34, 48], followed by a second peak at T7-T8 [41]. Overall, the junction of the thoracic and lumbar spine (T12-L1 vertebrae) is a critical site as far as vertebral fractures are concerned.…”

Section: Introductionmentioning

confidence: 99%

Human cancellous bone from T12–L1 vertebrae has unique microstructural and trabecular shear stress properties

Yeni

Divine

et al. 2009

Bone

View full text Add to dashboard Cite

Increase of trabecular stress variability with loss of bone mass has been implicated as a mechanism for increased cancellous bone fragility with age and disease. In the current study, a previous observation that trabecular shear stress estimates vary along the human spine such that the cancellous tissue from the thoracic 12 (T12)-lumbar 1 (L1) junction experiences the highest trabecular stresses for a given load was tested as a formal hypothesis using multiple human spines.Thoracic 4, T5, T7, T9, T10, T12, L1, L2, L4 and L5 vertebrae from 10 human cadaver spines were examined. One specimen in the central anterior region was cored in the supero-inferior (SI) direction and another in the postero-lateral region was cored in the transverse (TR) direction from each vertebra. Micro-CT-based large-scale finite element models were constructed for each specimen and compression in the long axis of the cylindrical specimens was simulated. Cancellous bone modulus and the mean, the standard deviation, variability and amplification of trabecular von Mises stresses were computed. Bone volume fraction, trabecular number, trabecular thickness, trabecular separation, connectivity density and degree of anisotropy were calculated using 3D stereology. The results were analyzed using a mixed model in which spine level was modeled using a quadratic polynomial. This research has been reviewed by the Institutional Review 47 Board and it was determined that there are no human rights concerns or patient privacy issues regarding this study. Therefore, it was exempt from continuing review by the IRB.This work was presented, in part, at the 54 th Annual Meeting of Orthopaedic Research Society, March 2-5, 2008, San Francisco, California.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptBone. Author manuscript; available in PMC 2010 January 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptThe maximum of trabecular shear stress amplification and minimum of bone volume fraction were found in the cancellous tissue from the T12-L1 location when results from the samples of the same vertebra were averaged. When groups were separated, microstructure and trabecular stresses varied with spine level, extrema being at the T12-L1 levels, for the TR specimens only. SI/TR ratio of measured parameters also had quadratic relationships with spine level, the extrema being located at T12-L1 levels for most parameters. For microstructural parameters, these ratios approached to a value of one at the T12-L1 level, suggesting that T12-L1 vertebrae have more ...

show abstract

Section: Introductionmentioning

confidence: 99%

Human cancellous bone from T12–L1 vertebrae has unique microstructural and trabecular shear stress properties

Yeni

Divine

et al. 2009

Bone

View full text Add to dashboard Cite

show abstract

“…Most vertebral fractures that occur during the first 15-20 years after the menopause often cause severe pain, while vertebral fracture diagnosed after 75 years are often painless (Riggs 1987); half of the vertebral fractures are asymptomatic (Gershon-Cohen et al 1953).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of vertebral fractures in 85-year-olds: Radiographic examination of 462 subjects

Johansson

Mellström

Rosengren

et al. 1993

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

Radiographic examinations for the presence of vertebral fracture between Th4-L5 were performed in a random sample of 85-year-old women (n 304) and men (n 158) who participated in a longitudinal population study. A moderate vertebral fracture was defined as an anterior/posterior vertebral height ratio of 0.66 or less. A severe vertebral fracture was defined as a compression of vertebral height of more than 33 percent both at the anterior and posterior edges compared to the posterior edge of the adjacent vertebral body. The prevalence of vertebral fractures was 25 percent in women and 13 percent in men. The ratio between moderate and severe grades of vertebral fracture was 1.5 for women and 2.1 for men. The most common site for vertebral fracture was L1 in women and Th12 in men. Women with vertebral fracture at 85 years of age had more back pain.

show abstract

“…Cultures of blood and urine yielded P mirabilis, and antibiotic therapy was administered. Roentgen- Uncertain origin 17 Total 372…”

Section: Reports Of Casesmentioning

confidence: 99%

Vertebral Osteomyelitis Presenting as Spinal Compression Fracture

McHenry

Duchesneau²,

Keys³

et al. 1988

Arch Intern Med

View full text Add to dashboard Cite

Asymptomatic Fractures in Osteoporotic Spines of the Aged

Cited by 76 publications

References 0 publications

Human cancellous bone from T12–L1 vertebrae has unique microstructural and trabecular shear stress properties

Human cancellous bone from T12–L1 vertebrae has unique microstructural and trabecular shear stress properties

Prevalence of vertebral fractures in 85-year-olds: Radiographic examination of 462 subjects

Vertebral Osteomyelitis Presenting as Spinal Compression Fracture

Contact Info

Product

Resources

About