The role of three-dimensional trabecular microstructure in the pathogenesis of vertebral compression fractures

Abstract

We compared indices of three-dimensional microstructure of iliac trabecular bone between 26 patients with vertebral compression fractures due to postmenopausal osteoporosis and 24 control subjects without vertebral fracture, who were matched for age, sex, race, menopausal status, and several densitometric and histologic indices of both cortical and trabecular bone mass. The patients with fracture had a significantly lower mean value (1.03 +/- 0.15 vs. 1.26 +/- 0.26; P less than 0.005) for indirectly calculated mean trabecular plate density, an index of the number and connectivity of structural elements, and as a necessary corollary, a significantly higher mean value for the mean thickness of structural elements. Plate density was more than one standard deviation below the age-adjusted mean value for normal postmenopausal white females in 19 (73%) of the fracture cases and in only 5 (21%) of the nonfracture cases (P less than 0.001). We conclude that the biomechanical competence of trabecular bone is dependent not only on the absolute amount of bone present but also on the trabecular microstructure.

The tyrosine kinase inhibitor dasatinib dysregulates bone remodeling through inhibition of osteoclasts in vivo

“…Previous studies have demonstrated that cancellous bone strength is determined primarily by trabecular geometry; increased cancellous bone strength is strongly associated with increased bone volume and trabecular thickness and by decreased Tb.Pf and SMI. (54)(55)(56) Therefore, our structural results indicate that dasatinib is able to positively affect trabecular bone architecture in normal rats, which is suggestive of an increase in bone strength. The potential effects of dasatinib on bone quality in patients undertaking long-term treatment need further elucidation.…”

Porous magnesium-based scaffolds for tissue engineering

“…26 site, reduced trabecular separation and higher trabecular number were observed, indicating formation of a more mature bone with a superior mechanical properties and osseointegration process [107,108].…”

Quantitative MRI for the assessment of bone structure and function

“…This study provided, for the first time, in vivo evidence for the architectural and mechanistic consequences of postmenopausal bone loss in that fracture subjects had lower surface-to-curve ratio and higher erosion index than their unfractured peers. Although it is well known that osteoporotic bone loss occurs through inhomogeneous resorption, which entails a conversion of plates to rods, along with disconnection of rods (115,117,130), this process had not previously been demonstrated by non-invasive imaging.…”