PDF(Pubmed)
Abstract：
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 t 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.
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 t 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.
摘要：
背景：椎体中的小梁在颈椎（CS）内分布不均，胸椎（TS），和腰椎（LS）。这样的结构也不均匀地分布在各个椎骨内。对这些实体的微观结构的确切了解可能会影响我们对骨质疏松症引起的骨折的理解和治疗，并可能改善手术方法。适当的调查可以帮助澄清不同形式的骨质疏松性椎体骨折的病理机制。以及小梁骨评分（TBS）等形态学发现的不同变化。在本研究中,我们在头尾和腹尾方向进行了穿刺，并从颈椎5和6，胸椎8和12以及腰椎1和3的中央部分和边缘区域获得了松质骨的圆柱体。我们系统分析了这些样本以确定骨体积分数，小梁厚度,分离,连接密度，各向异性程度，和结构模型索引。
方法：使用8号Jamshidi针头，我们从正面和横向平面的三个象限（QI：右侧边缘；QII：中央；QIII：左侧边缘）获得了样品，并用湿布在1.5mLEppendorf反应容器中制备了这些样品。调查是在微型CT设备上进行的(SKYSCAN1172，RJLMicro&AnalyticCompany，Karlsdorf-Neuthard,德国)。所有收集的数据均使用统计软件包SPSS（24.0版，IBMCorp.,Armonk,NY,美国）。学生t测试，Wilcoxon-Mann-Whitney检验,卡方检验，和单变量分析用于组间比较。检验的选择取决于被调查组的数量和正态分布的Shapiro-Wilk检验的结果。在具有统计学意义的结果的情况下，进行了事后LSD测试。
结果：总计，我们从20个身体捐献者中获得了360个骨骼样本。对于所有三个象限中的所有研究参数，颅尾穿刺产生了相似幅度的数据，在CS中观察到的最高值。腹背和颅尾微结构的比较显示，骨小梁密度明显降低，颅尾方向的各向异性程度明显更高。
结论：结果显示小梁密度的分布和行为不同，在椎骨的整个宽度上，椎骨中部区域的密度较低。小梁密度的降低导致了更高的各向异性，因此,与较低的维持生物力学负荷的能力有关。这种现象很容易解释鱼椎骨的骨折。这些结构的不同变化可能是原因，在某种程度上,使用双能X射线吸收法确定的TBS的变化。这些结果证实了TBS的临床相关性。
方法：使用8号Jamshidi针头，我们从正面和横向平面的三个象限（QI：右侧边缘；QII：中央；QIII：左侧边缘）获得了样品，并用湿布在1.5mLEppendorf反应容器中制备了这些样品。调查是在微型CT设备上进行的(SKYSCAN1172，RJLMicro&AnalyticCompany，Karlsdorf-Neuthard,德国)。所有收集的数据均使用统计软件包SPSS（24.0版，IBMCorp.,Armonk,NY,美国）。学生t测试，Wilcoxon-Mann-Whitney检验,卡方检验，和单变量分析用于组间比较。检验的选择取决于被调查组的数量和正态分布的Shapiro-Wilk检验的结果。在具有统计学意义的结果的情况下，进行了事后LSD测试。
结果：总计，我们从20个身体捐献者中获得了360个骨骼样本。对于所有三个象限中的所有研究参数，颅尾穿刺产生了相似幅度的数据，在CS中观察到的最高值。腹背和颅尾微结构的比较显示，骨小梁密度明显降低，颅尾方向的各向异性程度明显更高。
结论：结果显示小梁密度的分布和行为不同，在椎骨的整个宽度上，椎骨中部区域的密度较低。小梁密度的降低导致了更高的各向异性，因此,与较低的维持生物力学负荷的能力有关。这种现象很容易解释鱼椎骨的骨折。这些结构的不同变化可能是原因，在某种程度上,使用双能X射线吸收法确定的TBS的变化。这些结果证实了TBS的临床相关性。
