INTERVERTEBRAL VARIATION IN TRABECULAR MICROARCHITECTURE THROUGHOUT THE NORMAL SPINE IN RELATION TO AGE
INTERVERTEBRAL VARIATION IN TRABECULAR MICROARCHITECTURE THROUGHOUT THE NORMAL SPINE IN RELATION TO AGE
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DOI：
10.1016/8756-3282(94)00042-5
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发表时间：
1995-03-01
期刊：
影响因子：
4.1
通讯作者：
DELLING, G
中科院分区：
文献类型：
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作者：
GROTE, HJ;AMLING, M;DELLING, G
在26例无原发性或继发性骨病证据的尸检病例中（13例男性，年龄19-79岁，13例女性，年龄17-90岁），切除了完整脊柱（C-3-L-5）的椎体。将穿过所有椎体中心的矢状节段包埋在甲基丙烯酸羟乙酯中不脱钙，并加工成所谓的表面染色块研磨物。使用计算机辅助图像分析系统（IBAS 2000）对完整节段进行组织形态学分析。研究的结构参数为骨体积（BV/TV）和骨小梁互连（由骨小梁模式因子（TBPf）量化）。BV/TV与TBPf在所有椎体中均存在密切相关性（r = 0.8，p < 0.001）。这表明年龄相关的骨小梁骨量减少主要是由板状骨向杆状骨转化和整个骨小梁结构丧失的结果。这一基本原则适用于整个脊柱。然而，对C-3至L-5椎体骨小梁的系统分析揭示了骨小梁微结构的显著椎间变异。颈椎骨小梁结构密度明显高于胸腰椎（P < 0.001）。年龄相关的骨小梁质量和结构损失的程度显示脊柱内从尾部到头部区域减少（p < 0.05）。在30至80岁的个体中，腰椎的骨体积损失为53%，而胸椎的骨体积损失为41%，颈椎的骨体积损失仅为24%。在C-3和C-4中，未观察到与年龄相关的骨小梁结构密度的显著损失。单个椎骨的骨体积与其相应椎骨区域的平均值相差高达30%。本研究表明，腰椎骨小梁结构及其增龄性变化仅部分代表胸椎和颈椎。特别是对单个未测量椎体的结构预测，其价值有限。对骨折风险预测的后果进行了讨论。
The vertebral bodies of the complete spine (C-3-L-5) were removed in 26 autopsy cases without evidence for primary or secondary bone disease (13 males aged 19-79 years and 13 females aged 17-90 years). A sagittal segment through the center of all vertebral bodies was embedded undecalcified in hydroxyethylmethacrylate and processed to so-called surface stained block grindings. Histomorphometric analysis of the complete segment was performed using a computer-assisted image analysis system (IBAS 2000). The structural parameters investigated were bone volume (BV/TV) and trabecular interconnection quantificated by trabecular bone pattern factor (TBPf). A close correlation of BV/TV and TBPf was found in all vertebral bodies irrespective of vertebral region (r = 0.8, p < 0.001). This indicates that the age-related decrease of trabecular bone mass is primarily the consequence of the transformation from plates to rods and the loss of whole trabecular structures. This basic principle is valid throughout the complete spine. However, the systematic analysis of vertebral trabecular bone from C-3 to L-5 revealed a significant intervertebral variation of trabecular microarchitecture. The density of trabecular structure of cervical vertebrae is much higher than that of thoracic and lumbar vertebrae (p < 0.001). The extent of age related loss of trabecular bone mass and structure showed a decrease within the spine from the caudal to the cranial region (p < 0.05). The loss of bone volume in individuals between the ages of 30 and 80 years in the lumbar spine was 53%, whereas in the thoracic spine the decrease was 41%, and in the cervical spine only 24%. In C-3 and C-4 no significant age-related loss of trabecular structure density was observed. The bone volume of a single vertebra was noted to differ from the mean of its respective vertebral region by as much as 30%. The present study showed that trabecular structure of lumbar vertebrae and its age-related changes only partially represented thoracic and cervical vertebrae. It was of limited value, especially for the prediction of structure of a single unmeasured vertebral body, The consequences for the prediction of fracture risk were discussed.