Marianna L Oppenheimer-Velez1, Hugo Giambini2, Asghar Rezaei3, Jon J Camp4, Sundeep Khosla5, Lichun Lu6. 1. Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States; University of Puerto Rico Medical Sciences Campus, School of Medicine, San Juan, Puerto Rico. 2. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, United States. 3. Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States. 4. Biomedical Imaging Resource, Mayo Clinic, Rochester, MN, United States. 5. Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States. 6. Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States. Electronic address: lu.lichun@mayo.edu.
Abstract
BACKGROUND: Approximately 16-24% of postmenopausal women are affected by vertebral fractures, negatively affecting their quality of life. Trabecular and cortical bones in vertebrae decline differently with age, thus having a distinct impact on vertebral failure loads. The purpose of this study was to investigate the effect of trabecular and cortical volumetric bone mineral density loss over time on estimated failure loads; and to evaluate the effect of sex and age. METHOD: Fracture properties from a cohort of 82 patients were evaluated for L1-L3 vertebrae at baseline and 6th year using an image-based method that implements axial rigidity analysis. Cortical and trabecular volumetric bone mineral density were obtained, as well as their individual contribution to total failure load. Regression analyses were performed to determine the effect of age and sex on volumetric bone mineral density and failure loads. FINDINGS: Decline in trabecular and cortical volumetric bone mineral density, and failure load was sex-dependent (p ≤ 0.0095). Cortical and trabecular volumetric bone mineral density reduced 2.08 (g/cm3)/year and 2.02 (g/cm3)/year, respectively. A 1012 N difference in failure load, ~70% attributed to trabecular bone, was found between men and women of similar age. Over 6 years, this difference increased by 287 N. Areal bone mineral density measured by dual X-ray absorptiometry explained ~60% of the vertebral failure load. INTERPRETATION: Trabecular bone has a significantly greater effect than cortical bone on the structural integrity and load bearing capacity of vertebrae. This might lead to a higher incidence of fragility fractures in osteoporotic women. Our non-invasive, quantitative computed tomography image-based approach may improve prevention, monitoring, and management of fractures.
BACKGROUND: Approximately 16-24% of postmenopausal women are affected by vertebral fractures, negatively affecting their quality of life. Trabecular and cortical bones in vertebrae decline differently with age, thus having a distinct impact on vertebral failure loads. The purpose of this study was to investigate the effect of trabecular and cortical volumetric bone mineral density loss over time on estimated failure loads; and to evaluate the effect of sex and age. METHOD:Fracture properties from a cohort of 82 patients were evaluated for L1-L3 vertebrae at baseline and 6th year using an image-based method that implements axial rigidity analysis. Cortical and trabecular volumetric bone mineral density were obtained, as well as their individual contribution to total failure load. Regression analyses were performed to determine the effect of age and sex on volumetric bone mineral density and failure loads. FINDINGS: Decline in trabecular and cortical volumetric bone mineral density, and failure load was sex-dependent (p ≤ 0.0095). Cortical and trabecular volumetric bone mineral density reduced 2.08 (g/cm3)/year and 2.02 (g/cm3)/year, respectively. A 1012 N difference in failure load, ~70% attributed to trabecular bone, was found between men and women of similar age. Over 6 years, this difference increased by 287 N. Areal bone mineral density measured by dual X-ray absorptiometry explained ~60% of the vertebral failure load. INTERPRETATION: Trabecular bone has a significantly greater effect than cortical bone on the structural integrity and load bearing capacity of vertebrae. This might lead to a higher incidence of fragility fractures in osteoporoticwomen. Our non-invasive, quantitative computed tomography image-based approach may improve prevention, monitoring, and management of fractures.
Authors: Fernando Ruiz Santiago; Pablo Tomás Muñoz; Elena Moya Sánchez; Marta Revelles Paniza; Alberto Martínez Martínez; Antonio Luis Pérez Abela Journal: Quant Imaging Med Surg Date: 2016-12
Authors: Elizabeth J Samelson; Marian T Hannan; Yuqing Zhang; Harry K Genant; David T Felson; Douglas P Kiel Journal: J Bone Miner Res Date: 2006-08 Impact factor: 6.741
Authors: Asghar Rezaei; Hugo Giambini; Alan L Miller Ii; Hao Xu; Haocheng Xu; Yong Li; Michael J Yaszemski; Lichun Lu Journal: Comput Biol Med Date: 2021-04-19 Impact factor: 6.698