Determinants and heterogeneity thoracolumbar spine of mechanical competence throughout the of elderly women and men
Determinants and heterogeneity thoracolumbar spine of mechanical competence throughout the of elderly women and men
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DOI：
10.1016/j.bone.2004.04.008
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发表时间：
2004-08-01
期刊：
影响因子：
4.1
通讯作者：
Lochmüller, EM
中科院分区：
文献类型：
--
作者：
Eckstein, F;Fischbeck, M;Lochmüller, EM
脊椎骨折是骨质疏松症的标志。在这里，我们测试的假设，（下）皮质骨强度和密度预测失败比骨小梁核心强度和密度，老年妇女显示较低的失败应力的胸椎比男性。我们检查了39例老年供体（23例女性; 16例男性;年龄79 ± 11岁）脊柱的T3至L5椎体。外周定量计算机断层扫描用于测量总骨密度、骨小梁密度和（亚）皮质骨密度。在功能性脊柱单元、椎骨的平面平行切片、骨小梁核心和（亚）皮质环标本中进行力学测试。破坏应力随椎体水平下降而降低。破坏应力最高的（下）皮质环和planocallantic部分和最低的小梁核心。失败压力在男性和女性之间没有显著差异。功能单位的机械强度与皮质环强度（r = 0.78）的相关性比与小梁核心强度（r = 0.62）的相关性更强。然而，总密度与同一和远端椎骨的机械强度（r = 0.63）比骨小梁（r = 0.50）或（亚）皮质密度（r = 0.36），分别更高。结果表明，老年女性和男性的椎骨强度相似。皮质骨强度对功能性脊柱单位强度的预测明显优于骨小梁核心。然而，总密度预测功能段失效应力的准确性高于（下）皮质或骨小梁密度，因此推荐用于临床预测骨折强度。(C)2004年爱思唯尔公司All rights reserved.
Vertebral fractures represent the hallmark of osteoporosis. Here, we test the hypotheses that (sub)cortical bone strength and density predict failure better than trabecular core strength and density, and that elderly women display lower failure stress of thoracic vertebrae than men. We examined the vertebral bodies T3 to L5 in 39 spines from elderly donors (23 women; 16 men; age 79 +/- 11 years). Peripheral quantitative computed tomography was used to measure total, trabecular, and (sub)cortical bone density. Mechanical tests were performed in functional spinal units, planoparallel sections of vertebrae, trabecular cores, and (sub)cortical ring specimens. The failure stress decreased with descending vertebral level. Failure stress was highest for the (sub)cortical rings and planoparallel sections and lowest for the trabecular core. The failure stress did not differ significantly between men and women. Mechanical strength of the functional unit was more strongly correlated with the strength of the (sub)cortical ring (r = 0.78) than with that of the trabecular core (r = 0.62). However, total density was more highly correlated with mechanical strength of the same and remote vertebrae (r = 0.63) than trabecular (r = 0.50) or (sub)cortical density (r = 0.36), respectively. The results show that vertebral strength is similar in elderly women and men. Strength of (sub)cortical bone provides significantly better prediction of strength of functional spinal units than that of the trabecular core. However, total density predicts functional segment failure stress with higher accuracy than (sub)cortical or trabecular density and is thus recommended for predicting fracture strength clinically. (C) 2004 Elsevier Inc. All rights reserved.