Prediction of the compressive strength of vertebral bodies of the lumbar spine by quantitative computed tomography

Biggemann, M; Hilweg, D; Brinckmann, Paul

doi:10.1007/bf00401809

Cited by 96 publications

(45 citation statements)

References 17 publications

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“…Our findings corroborate numerous in vitro studies indicating that the compressive strength of the vertebra is determined not only by its bone density ( 13,(24)(25)(26)(27)(28)(29)(30), but also by its crosssectional area ( 13,30,31 ). The cross-sectional area of vertebral bodies is designed to bear mechanical loads that are progressively larger caudally as the superimposed weight of the upper body increases.…”

Section: Discussionsupporting

confidence: 90%

Vertebral size in elderly women with osteoporosis. Mechanical implications and relationship to fractures.

Gilsanz

Loro²,

Roe³

et al. 1995

J. Clin. Invest.

149

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Reductions in bone density are a major determinant of vertebral fractures in the elderly population. However, women have a greater incidence of fractures than men, although their spinal bone densities are comparable. Recent observations indicate that women have 20-25% smaller vertebrae than men after accounting for differences in body size. To assess whether elderly women with vertebral fractures have smaller vertebrae than women who do not experience fractures, we reviewed 1,061 computed tomography bone density studies and gathered 32-matched pairs of elderly women, with reduced bone density, whose main difference was absence or presence of vertebral fractures. Detailed measurements of the dimensions of unfractured vertebrae and the moment arm of spinal musculature from T12 to L4 were calculated from computed tomography images in the 32 pairs of women matched for race, age, height, weight, and bone density. The cross-sectional area of unfractured vertebrae was 4.9-11.5% (10.5±1.4 vs 9.7±1.5 cm2; P < 0.0001) smaller and the moment arm of spinal musculature was 3.2-7.4% (56.4±5.1 vs 53.1±4.4 mm; P < 0.0001) shorter in women with fractures, implying that mechanical stress within intact vertebral bodies for equivalent loads is 5-17% greater in women with fractures compared to women without fractures. Such significant variations are very likely to contribute to vertebral fractures in osteoporotic women. (J. Clin. Invest. 1995. 95:2332-2337

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Section: Discussionsupporting

confidence: 90%

Vertebral size in elderly women with osteoporosis. Mechanical implications and relationship to fractures.

Gilsanz

Loro²,

Roe³

et al. 1995

J. Clin. Invest.

149

View full text Add to dashboard Cite

show abstract

“…The loads encountered in daily life are a function of body weight, height, and bending moments [15]. The ability to resist them is a function of the cross sectional area and vBMD of the bone [1]. In principle, the ratio of applied load to whole bone strength should predict fracture risk more efficiently than BMD measurements alone [25].…”

Section: Discussionmentioning

confidence: 99%

Trabecular Bone Mechanical Properties in Patients with Fragility Fractures

Kreider

Goldstein

2009

Clinical Orthopaedics &Amp; Related Research

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Fragility fractures are generally associated with substantial loss in trabecular bone mass and alterations in structural anisotropy. Despite the high correlations between measures of trabecular mass and mechanical properties, significant overlap in density measures exists between individuals with osteoporosis and those who do not fracture. The purpose of this paper is to provide an analysis of trabecular properties associated with fragility fractures. While accurate measures of bone mass and 3-D orientation have been demonstrated to explain 80% to 90% of the variance in mechanical behavior, clinical and experimental experience suggests the unexplained proportion of variance may be a key determinant in separating high-and low-risk patients. Using a hierarchical perspective, we demonstrate the potential contributions of structural and tissue morphology, material properties, and chemical composition to the apparent mechanical properties of trabecular bone. The results suggest that the propensity for an individual to remodel or adapt to habitual damaging or nondamaging loads may distinguish them in terms of risk for failure.

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“…At low loads, the compliance of the FSU is mainly achieved through the medial or sagittal bulging of the IVD. However, at higher loads additional compliance is realized through the deformation of the endplates [4,5]. Disc health affects the manner in which endplates are loaded.…”

Section: Discussionmentioning

confidence: 99%

Differences in endplate deformation of the adjacent and augmented vertebra following cement augmentation

et al. 2009

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Prediction of the compressive strength of vertebral bodies of the lumbar spine by quantitative computed tomography

Cited by 96 publications

References 17 publications

Vertebral size in elderly women with osteoporosis. Mechanical implications and relationship to fractures.

Vertebral size in elderly women with osteoporosis. Mechanical implications and relationship to fractures.

Trabecular Bone Mechanical Properties in Patients with Fragility Fractures

Differences in endplate deformation of the adjacent and augmented vertebra following cement augmentation

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