Regional Variations in the Intra- and Intervertebral Trabecular Microarchitecture of the Osteoporotic Axial Skeleton with Reference to the Direction of Puncture
Background: Trabeculae in vertebral bodies are unequally distributed within the cervical spine (CS), the thoracic spine (TS), and lumbar spine (LS). Such structures are also unequally distributed within the individual vertebrae. Exact knowledge of the microstructure of these entities could impact ou...
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MDPI AG
2024-02-01
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| Online Access: | https://www.mdpi.com/2075-4418/14/5/498 |
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| author | Guido Schröder Thomas Mittlmeier Patrick Gahr Sahra Ulusoy Laura Hiepe Marko Schulze Andreas Götz Reimer Andresen Hans-Christof Schober |
| author_facet | Guido Schröder Thomas Mittlmeier Patrick Gahr Sahra Ulusoy Laura Hiepe Marko Schulze Andreas Götz Reimer Andresen Hans-Christof Schober |
| author_sort | Guido Schröder |
| collection | DOAJ |
| description | Background: Trabeculae in vertebral bodies are unequally distributed within the cervical spine (CS), the thoracic spine (TS), and lumbar spine (LS). Such structures are also unequally distributed within the individual vertebrae. Exact knowledge of the microstructure of these entities could impact our understanding and treatment of fractures caused by osteoporosis and possibly improve surgical approaches. Appropriate investigations could help clarify the pathomechanisms of different forms of osteoporotic vertebral fractures, as well as different changes in morphological findings like the trabecular bone score (TBS). In the present study, we applied punctures to the craniocaudal and ventrocaudal directions and obtained cylinders of cancellous bone from the central portions and marginal regions of cervical vertebrae 5 and 6, thoracic vertebrae 8 and 12, and lumbar vertebrae 1 and 3. We systematically analyzed these samples to determine the bone volume fraction, trabecular thickness, separation, connectivity density, degree of anisotropy, and structure model index. Methods: Using an 8-gauge Jamshidi needle, we obtained samples from three quadrants (Q I: right margin; Q II: central; Q III: left margin) in the frontal and transverse plane and prepared these samples with a moist cloth in a 1.5 mL Eppendorf reaction vessel. The investigations were performed on a micro-CT device (SKYSCAN 1172, RJL Micro & Analytic Company, Karlsdorf-Neuthard, Germany). All collected data were analyzed using the statistical software package SPSS (version 24.0, IBM Corp., Armonk, NY, USA). Student’s <i>t</i> test, the Wilcoxon–Mann–Whitney test, the Chi-squared test, and univariate analysis were used for between-group comparisons. The selection of the test depended on the number of investigated groups and the result of the Shapiro–Wilk test of normal distribution. In the case of statistically significant results, a post hoc LSD test was performed. Results: In total, we obtained 360 bone samples from 20 body donors. The craniocaudal puncture yielded data of similar magnitudes for all investigated parameters in all three quadrants, with the highest values observed in the CS. Comparisons of the ventrodorsal and craniocaudal microstructure revealed a significantly lower trabecular density and a significantly higher degree of anisotropy in the craniocaudal direction. Conclusions: The results presented different distributions and behaviors of trabecular density, with lower density in the mid-vertebral region over the entire breadth of the vertebrae. Reduced trabecular density caused a higher degree of anisotropy and was, therefore, associated with a lower capacity to sustain biomechanical loads. Fractures in fish vertebrae were easily explained by this phenomenon. The different changes in these structures could be responsible, in part, for the changes in the TBS determined using dual-energy X-ray absorptiometry. These results confirm the clinical relevance of the TBS. |
| first_indexed | 2024-04-25T00:31:56Z |
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| spelling | doaj.art-26c14877b9dd4d53a296aca17d1e41ff2024-03-12T16:41:58ZengMDPI AGDiagnostics2075-44182024-02-0114549810.3390/diagnostics14050498Regional Variations in the Intra- and Intervertebral Trabecular Microarchitecture of the Osteoporotic Axial Skeleton with Reference to the Direction of PunctureGuido Schröder0Thomas Mittlmeier1Patrick Gahr2Sahra Ulusoy3Laura Hiepe4Marko Schulze5Andreas Götz6Reimer Andresen7Hans-Christof Schober8Department of Traumatology, Hand and Reconstructive Surgery, Rostock University Medical Center, Schillingallee 35, 18057 Rostock, GermanyDepartment of Traumatology, Hand and Reconstructive Surgery, Rostock University Medical Center, Schillingallee 35, 18057 Rostock, GermanyDepartment of Traumatology, Hand and Reconstructive Surgery, Rostock University Medical Center, Schillingallee 35, 18057 Rostock, GermanyFaculty of Medicine, University of Rostock, Ernst-Heydemann-Str. 8, 18057 Rostock, GermanyInstitute of Anatomy, Rostock University Medical Center, Gertrudenstraße 9, 18057 Rostock, GermanyInstitute of Anatomy and Cell Biology, University of Bielefeld, Morgenbreede 1, 33615 Bielefeld, GermanyInstitute for Biomedical Engineering, University Medical Center Rostock, Friedrich-Barnewitz-Straße 4, 18119 Rostock-Warnemuende, GermanyInstitute for Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck und Hamburg, Esmarchstraße 50, 25746 Heide, GermanyOrthoCoast, Practice for Orthopedics and Osteology, Hufelandstraße 1, 17438 Wolgast, GermanyBackground: Trabeculae in vertebral bodies are unequally distributed within the cervical spine (CS), the thoracic spine (TS), and lumbar spine (LS). Such structures are also unequally distributed within the individual vertebrae. Exact knowledge of the microstructure of these entities could impact our understanding and treatment of fractures caused by osteoporosis and possibly improve surgical approaches. Appropriate investigations could help clarify the pathomechanisms of different forms of osteoporotic vertebral fractures, as well as different changes in morphological findings like the trabecular bone score (TBS). In the present study, we applied punctures to the craniocaudal and ventrocaudal directions and obtained cylinders of cancellous bone from the central portions and marginal regions of cervical vertebrae 5 and 6, thoracic vertebrae 8 and 12, and lumbar vertebrae 1 and 3. We systematically analyzed these samples to determine the bone volume fraction, trabecular thickness, separation, connectivity density, degree of anisotropy, and structure model index. Methods: Using an 8-gauge Jamshidi needle, we obtained samples from three quadrants (Q I: right margin; Q II: central; Q III: left margin) in the frontal and transverse plane and prepared these samples with a moist cloth in a 1.5 mL Eppendorf reaction vessel. The investigations were performed on a micro-CT device (SKYSCAN 1172, RJL Micro & Analytic Company, Karlsdorf-Neuthard, Germany). All collected data were analyzed using the statistical software package SPSS (version 24.0, IBM Corp., Armonk, NY, USA). Student’s <i>t</i> test, the Wilcoxon–Mann–Whitney test, the Chi-squared test, and univariate analysis were used for between-group comparisons. The selection of the test depended on the number of investigated groups and the result of the Shapiro–Wilk test of normal distribution. In the case of statistically significant results, a post hoc LSD test was performed. Results: In total, we obtained 360 bone samples from 20 body donors. The craniocaudal puncture yielded data of similar magnitudes for all investigated parameters in all three quadrants, with the highest values observed in the CS. Comparisons of the ventrodorsal and craniocaudal microstructure revealed a significantly lower trabecular density and a significantly higher degree of anisotropy in the craniocaudal direction. Conclusions: The results presented different distributions and behaviors of trabecular density, with lower density in the mid-vertebral region over the entire breadth of the vertebrae. Reduced trabecular density caused a higher degree of anisotropy and was, therefore, associated with a lower capacity to sustain biomechanical loads. Fractures in fish vertebrae were easily explained by this phenomenon. The different changes in these structures could be responsible, in part, for the changes in the TBS determined using dual-energy X-ray absorptiometry. These results confirm the clinical relevance of the TBS.https://www.mdpi.com/2075-4418/14/5/498micro-CTosteoporosisinsufficiency fracturecancellous bone structurespine |
| spellingShingle | Guido Schröder Thomas Mittlmeier Patrick Gahr Sahra Ulusoy Laura Hiepe Marko Schulze Andreas Götz Reimer Andresen Hans-Christof Schober Regional Variations in the Intra- and Intervertebral Trabecular Microarchitecture of the Osteoporotic Axial Skeleton with Reference to the Direction of Puncture Diagnostics micro-CT osteoporosis insufficiency fracture cancellous bone structure spine |
| title | Regional Variations in the Intra- and Intervertebral Trabecular Microarchitecture of the Osteoporotic Axial Skeleton with Reference to the Direction of Puncture |
| title_full | Regional Variations in the Intra- and Intervertebral Trabecular Microarchitecture of the Osteoporotic Axial Skeleton with Reference to the Direction of Puncture |
| title_fullStr | Regional Variations in the Intra- and Intervertebral Trabecular Microarchitecture of the Osteoporotic Axial Skeleton with Reference to the Direction of Puncture |
| title_full_unstemmed | Regional Variations in the Intra- and Intervertebral Trabecular Microarchitecture of the Osteoporotic Axial Skeleton with Reference to the Direction of Puncture |
| title_short | Regional Variations in the Intra- and Intervertebral Trabecular Microarchitecture of the Osteoporotic Axial Skeleton with Reference to the Direction of Puncture |
| title_sort | regional variations in the intra and intervertebral trabecular microarchitecture of the osteoporotic axial skeleton with reference to the direction of puncture |
| topic | micro-CT osteoporosis insufficiency fracture cancellous bone structure spine |
| url | https://www.mdpi.com/2075-4418/14/5/498 |
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