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Tabassum A, Singh MKC, Ibrahim N, Sanjeevan V, Yusof MYPM. Trabecular bone microstructure parameters as predictors for chronological age: a systematic review. Forensic Sci Med Pathol 2024:10.1007/s12024-024-00864-x. [PMID: 39098862 DOI: 10.1007/s12024-024-00864-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2024] [Indexed: 08/06/2024]
Abstract
Estimating chronological age is crucial in forensic identification. The increased application of medical imaging in age analysis has facilitated the development of new quantitative methods for the macroscopic evaluation of bones. This study aimed to determine the association of age-related changes in the trabecular microstructure with chronological age for age estimation in forensic science through different non-invasive imaging techniques. This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. An electronic search was performed with PubMed/MEDLINE, Scopus, and Cochrane databases as well as with a Google Scholar search. Qualitative synthesis was performed using the Anatomical Quality Assessment tool. A detailed literature search yielded 3467 articles. A total of 14 articles were ultimately included in the study. A narrative approach was employed to synthesize the data. Microcomputed tomography, high-resolution peripheral quantitative computed tomography, and cone beam computed tomography have been used for the quantitative estimation of age. These imaging techniques aid in identifying the trabecular bone microarchitectural parameters for chronological age estimation. Age-related changes in trabecular bone included a decrease in the bone volume fraction, trabecular number, and connectivity density and an increase in trabecular separation. This study also revealed that morphometric indices vary with age and anatomical site. This study is registered with the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CDRD42023391873.
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Affiliation(s)
- Arshiya Tabassum
- Center for Oral and Maxillofacial Diagnostics and Medicine Studies, Faculty of Dentistry, Universiti Teknologi MARA Selangor, Sungai Buloh, Selangor, Malaysia
| | - Mansharan Kaur Chainchel Singh
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA Selangor, Sungai Buloh, Selangor, Malaysia
| | - Norliza Ibrahim
- Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Vinita Sanjeevan
- Department of Public Health Dentistry, Goa Dental College & Hospital, Bambolim, North Goa- Goa, 403202, India
| | - Mohd Yusmiaidil Putera Mohd Yusof
- Center for Oral and Maxillofacial Diagnostics and Medicine Studies, Faculty of Dentistry, Universiti Teknologi MARA Selangor, Sungai Buloh, Selangor, Malaysia.
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA Selangor, Sungai Buloh, Selangor, Malaysia.
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Amorim T, Kumar NG, David NL, Dion W, Pagadala T, Doshi NK, Zhu B, Parkhitko A, Steinhauser ML, Fazeli PK. Methionine as a regulator of bone remodeling with fasting. JCI Insight 2024; 9:e177997. [PMID: 38780544 PMCID: PMC11383369 DOI: 10.1172/jci.insight.177997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
Caloric restriction improves metabolic health but is often complicated by bone loss. We studied bone parameters in humans during a 10-day fast and identified candidate metabolic regulators of bone turnover. Pro-collagen 1 intact N-terminal pro-peptide (P1NP), a bone formation marker, decreased within 3 days of fasting. Whereas dual-energy x-ray absorptiometry measures of bone mineral density were unchanged after 10 days of fasting, high-resolution peripheral quantitative CT demonstrated remodeling of bone microarchitecture. Pathway analysis of longitudinal metabolomics data identified one-carbon metabolism as fasting dependent. In cultured osteoblasts, we tested the functional significance of one-carbon metabolites modulated by fasting, finding that methionine - which surged after 3 days of fasting - affected markers of osteoblast cell state in a concentration-dependent manner, in some instances exhibiting a U-shaped response with both low and high concentrations driving putative antibone responses. Administration of methionine to mice for 5 days recapitulated some fasting effects on bone, including a reduction in serum P1NP. In conclusion, a 10-day fast in humans led to remodeling of bone microarchitecture, potentially mediated by a surge in circulating methionine. These data support an emerging model that points to a window of optimal methionine exposure for bone health.
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Affiliation(s)
- Tânia Amorim
- Aging Institute of UPMC and University of Pittsburgh School of Medicine
- Neuroendocrinology Unit, Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh School of Medicine
- Center for Human Integrative Physiology, Aging Institute of UPMC and University of Pittsburgh School of Medicine
| | - Naveen Gv Kumar
- Aging Institute of UPMC and University of Pittsburgh School of Medicine
| | - Natalie L David
- Aging Institute of UPMC and University of Pittsburgh School of Medicine
- Neuroendocrinology Unit, Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh School of Medicine
- Center for Human Integrative Physiology, Aging Institute of UPMC and University of Pittsburgh School of Medicine
| | - William Dion
- Aging Institute of UPMC and University of Pittsburgh School of Medicine
| | - Trishya Pagadala
- Aging Institute of UPMC and University of Pittsburgh School of Medicine
| | - Nandini K Doshi
- Aging Institute of UPMC and University of Pittsburgh School of Medicine
- Center for Human Integrative Physiology, Aging Institute of UPMC and University of Pittsburgh School of Medicine
| | - Bokai Zhu
- Aging Institute of UPMC and University of Pittsburgh School of Medicine
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh School of Medicine; and
| | - Andrey Parkhitko
- Aging Institute of UPMC and University of Pittsburgh School of Medicine
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh School of Medicine; and
| | - Matthew L Steinhauser
- Aging Institute of UPMC and University of Pittsburgh School of Medicine
- Center for Human Integrative Physiology, Aging Institute of UPMC and University of Pittsburgh School of Medicine
- Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Pouneh K Fazeli
- Neuroendocrinology Unit, Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh School of Medicine
- Center for Human Integrative Physiology, Aging Institute of UPMC and University of Pittsburgh School of Medicine
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Galassi FM, Lorkiewicz W, Filipiak J, Nikodem A, Żądzińska E. Age- and sex-related changes in vertebral trabecular bone architecture in Neolithic and Mediaeval populations from Poland. Sci Rep 2024; 14:9977. [PMID: 38693297 PMCID: PMC11063184 DOI: 10.1038/s41598-024-59946-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 04/17/2024] [Indexed: 05/03/2024] Open
Abstract
This paper investigates trabecular bone ontogenetic changes in two different Polish populations, one prehistoric and the other historical. The studied populations are from the Brześć Kujawski region in Kujawy (north-central Poland), one from the Neolithic Period (4500-4000 BC) and one from the Middle Ages (twelfth-sixteenth centuries AD), in total 62 vertebral specimens (32 males, 30 females). Eight morphometric parameters acquired from microCT scan images were analysed. Two-way ANOVA after Box-Cox transformation and multifactorial regression model were calculated. A significant decrease in percentage bone volume fraction (BV/TV; [%]) with age at death was observed in the studied sample; Tb.N (trabecular number) was also significantly decreased with age; trabecular separation (Tb.Sp) increased with advancing age; connectivity density (Conn.D) was negatively correlated with biological age and higher in the Neolithic population. These data are found to be compatible with data from the current biomedical literature, while no loss of horizontal trabeculae was recorded as would be expected based on modern osteoporosis.
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Affiliation(s)
- Francesco Maria Galassi
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland.
| | - Wiesław Lorkiewicz
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Jarosław Filipiak
- Department of Mechanics, Materials and Biomedical Engineering, Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, Wrocław, Poland
| | - Anna Nikodem
- Department of Mechanics, Materials and Biomedical Engineering, Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, Wrocław, Poland
| | - Elżbieta Żądzińska
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
- Biological Anthropology and Comparative Anatomy Research Unit, School of Medicine, University of Adelaide, Adelaide, SA, 5005, Australia
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Otagiri T, Sato N, Shiozaki T, Harayama Y, Matsumoto M, Kobayashi K, Asamura H. An optimal skeletal element for DNA testing: Evaluation of DNA quantity and quality from various bone types in routine forensic practice. Leg Med (Tokyo) 2024; 68:102415. [PMID: 38280273 DOI: 10.1016/j.legalmed.2024.102415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/19/2023] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
For human identification, the quality and quantity of DNA must be sufficient for amplification and analysis. When DNA extraction from bone tissues and teeth is required, the optimal skeletal elements should be selected as samples for DNA extraction because DNA yield differs among elements. Recently, some studies have reported that a high quantity of high-quality DNA can be extracted from the small cancellous bones of the hands and feet. In this study, we evaluated the effectiveness of small cancellous bones in the human identification of skeletal remains in routine forensic genetic casework. Cancellous bones [phalanges, (meta)carpal bones, and (meta)tarsal bones)] and the cortical bones (femur and petrous bones) and teeth, which have generally been recommended as samples, were collected from the same individuals that needed identifying using DNA analysis in our laboratory. The quantity of DNA from small cancellous bones tended to be higher than that from cortical bones, and the quality from the former was as high as that from the latter. This study showed that in routine forensic casework, the small cancellous bones of the hands and feet should be actively selected as samples for DNA testing.
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Affiliation(s)
- Tomomi Otagiri
- Department of Legal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan.
| | - Noriko Sato
- Department of Legal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan.
| | - Tetsuya Shiozaki
- Department of Legal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan.
| | - Yuta Harayama
- Department of Legal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan.
| | - Momoe Matsumoto
- Department of Legal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan.
| | - Kanya Kobayashi
- Department of Legal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan.
| | - Hideki Asamura
- Department of Legal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan.
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Schröder G, Mittlmeier T, Gahr P, Ulusoy S, Hiepe L, Schulze M, Götz A, Andresen R, Schober HC. Regional Variations in the Intra- and Intervertebral Trabecular Microarchitecture of the Osteoporotic Axial Skeleton with Reference to the Direction of Puncture. Diagnostics (Basel) 2024; 14:498. [PMID: 38472970 DOI: 10.3390/diagnostics14050498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 03/14/2024] Open
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.
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Affiliation(s)
- Guido Schröder
- Department of Traumatology, Hand and Reconstructive Surgery, Rostock University Medical Center, Schillingallee 35, 18057 Rostock, Germany
| | - Thomas Mittlmeier
- Department of Traumatology, Hand and Reconstructive Surgery, Rostock University Medical Center, Schillingallee 35, 18057 Rostock, Germany
| | - Patrick Gahr
- Department of Traumatology, Hand and Reconstructive Surgery, Rostock University Medical Center, Schillingallee 35, 18057 Rostock, Germany
| | - Sahra Ulusoy
- Faculty of Medicine, University of Rostock, Ernst-Heydemann-Str. 8, 18057 Rostock, Germany
| | - Laura Hiepe
- Institute of Anatomy, Rostock University Medical Center, Gertrudenstraße 9, 18057 Rostock, Germany
| | - Marko Schulze
- Institute of Anatomy and Cell Biology, University of Bielefeld, Morgenbreede 1, 33615 Bielefeld, Germany
| | - Andreas Götz
- Institute for Biomedical Engineering, University Medical Center Rostock, Friedrich-Barnewitz-Straße 4, 18119 Rostock-Warnemuende, Germany
| | - Reimer Andresen
- Institute for Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck und Hamburg, Esmarchstraße 50, 25746 Heide, Germany
| | - Hans-Christof Schober
- OrthoCoast, Practice for Orthopedics and Osteology, Hufelandstraße 1, 17438 Wolgast, Germany
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Marupudi S, Cao Q, Samala R, Petrick N. Characterization of mechanical stiffness using additive manufacturing and finite element analysis: potential tool for bone health assessment. 3D Print Med 2023; 9:32. [PMID: 37978094 PMCID: PMC10656885 DOI: 10.1186/s41205-023-00197-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Bone health and fracture risk are known to be correlated with stiffness. Both micro-finite element analysis (μFEA) and mechanical testing of additive manufactured phantoms are useful approaches for estimating mechanical properties of trabecular bone-like structures. However, it is unclear if measurements from the two approaches are consistent. The purpose of this work is to evaluate the agreement between stiffness measurements obtained from mechanical testing of additive manufactured trabecular bone phantoms and μFEA modeling. Agreement between the two methods would suggest 3D printing is a viable method for validation of μFEA modeling. METHODS A set of 20 lumbar vertebrae regions of interests were segmented and the corresponding trabecular bone phantoms were produced using selective laser sintering. The phantoms were mechanically tested in uniaxial compression to derive their stiffness values. The stiffness values were also derived from in silico simulation, where linear elastic μFEA was applied to simulate the same compression and boundary conditions. Bland-Altman analysis was used to evaluate agreement between the mechanical testing and μFEA simulation values. Additionally, we evaluated the fidelity of the 3D printed phantoms as well as the repeatability of the 3D printing and mechanical testing process. RESULTS We observed good agreement between the mechanically tested stiffness and μFEA stiffness, with R2 of 0.84 and normalized root mean square deviation of 8.1%. We demonstrate that the overall trabecular bone structures are printed in high fidelity (Dice score of 0.97 (95% CI, [0.96,0.98]) and that mechanical testing is repeatable (coefficient of variation less than 5% for stiffness values from testing of duplicated phantoms). However, we noticed some defects in the resin microstructure of the 3D printed phantoms, which may account for the discrepancy between the stiffness values from simulation and mechanical testing. CONCLUSION Overall, the level of agreement achieved between the mechanical stiffness and μFEA indicates that our μFEA methods may be acceptable for assessing bone mechanics of complex trabecular structures as part of an analysis of overall bone health.
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Affiliation(s)
- Sriharsha Marupudi
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Labs, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Qian Cao
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Labs, U.S. Food and Drug Administration, Silver Spring, MD, USA.
| | - Ravi Samala
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Labs, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Nicholas Petrick
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Labs, U.S. Food and Drug Administration, Silver Spring, MD, USA
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Gassert FT, Urban T, Kufner A, Frank M, Feuerriegel GC, Baum T, Makowski MR, Braun C, Pfeiffer D, Schwaiger BJ, Pfeiffer F, Gersing AS. Dark-field X-ray imaging for the assessment of osteoporosis in human lumbar spine specimens. Front Physiol 2023; 14:1217007. [PMID: 37534364 PMCID: PMC10393038 DOI: 10.3389/fphys.2023.1217007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023] Open
Abstract
Background: Dark-field imaging is a novel imaging modality that allows for the assessment of material interfaces by exploiting the wave character of x-ray. While it has been extensively studied in chest imaging, only little is known about the modality for imaging other tissues. Therefore, the purpose of this study was to evaluate whether a clinical X-ray dark-field scanner prototype allows for the assessment of osteoporosis. Materials and methods: In this prospective study we examined human cadaveric lumbar spine specimens (vertebral segments L2 to L4). We used a clinical prototype for dark-field radiography that yields both attenuation and dark-field images. All specimens were scanned in lateral orientation in vertical and horizontal position. All specimens were additionally imaged with CT as reference. Bone mineral density (BMD) values were derived from asynchronously calibrated quantitative CT measurements. Correlations between attenuation signal, dark-field signal and BMD were assessed using Spearman's rank correlation coefficients. The capability of the dark-field signal for the detection of osteoporosis/osteopenia was evaluated with receiver operating characteristics (ROC) curve analysis. Results: A total of 58 vertebrae from 20 human cadaveric spine specimens (mean age, 73 years ±13 [standard deviation]; 11 women) were studied. The dark-field signal was positively correlated with the BMD, both in vertical (r = 0.56, p < .001) and horizontal position (r = 0.43, p < .001). Also, the dark-field signal ratio was positively correlated with BMD (r = 0.30, p = .02). No correlation was found between the signal ratio of attenuation signal and BMD (r = 0.14, p = .29). For the differentiation between specimens with and without osteoporosis/osteopenia, the area under the ROC curve (AUC) was 0.80 for the dark-field signal in vertical position. Conclusion: Dark-field imaging allows for the differentiation between spine specimens with and without osteoporosis/osteopenia and may therefore be a potential biomarker for bone stability.
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Affiliation(s)
- Florian T. Gassert
- Department of Diagnostic and Interventional Radiology, School of Medicine and Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Theresa Urban
- Department of Diagnostic and Interventional Radiology, School of Medicine and Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, Garching, Germany
| | - Alexander Kufner
- Department of Diagnostic and Interventional Radiology, School of Medicine and Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Manuela Frank
- Department of Diagnostic and Interventional Radiology, School of Medicine and Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, Garching, Germany
| | - Georg C. Feuerriegel
- Department of Diagnostic and Interventional Radiology, School of Medicine and Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas Baum
- Department of Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Marcus R. Makowski
- Department of Diagnostic and Interventional Radiology, School of Medicine and Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christian Braun
- Institute of Forensic Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, School of Medicine and Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Munich Institute for Advanced Study, Technical University of Munich, Garching, Germany
| | - Benedikt J. Schwaiger
- Department of Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Franz Pfeiffer
- Department of Diagnostic and Interventional Radiology, School of Medicine and Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, Garching, Germany
- Munich Institute for Advanced Study, Technical University of Munich, Garching, Germany
| | - Alexandra S. Gersing
- Department of Neuroradiology, University Hospital of Munich, LMU Munich, Munich, Germany
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Schröder G, Baginski AM, Schulze M, Hiepe L, Bugaichuk S, Martin H, Andresen JR, Moritz M, Andresen R, Schober HC. Regional variations in the intra- and intervertebral trabecular microarchitecture of the osteoporotic axial skeleton. Anat Sci Int 2023:10.1007/s12565-023-00726-6. [PMID: 37093524 DOI: 10.1007/s12565-023-00726-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
Trabecular structures in vertebral bodies are unequally distributed in the cervical, thoracic and lumbar spine, and also within individual vertebrae. Knowledge of the microstructure of these entities could influence our comprehension and treatment of osteoporotic fractures, and even surgical procedures. Appropriate investigations may clarify the pathomechanisms of various osteoporotic fractures (fish, wedge-shaped, and flat vertebrae). We obtained three cancellous bone cylinders from the centers and margins of cervical vertebra 3 to lumbar vertebra 5, and investigated these in regard of bone volume fraction, trabecular thickness, separation, trabecular number, trabecular bone pattern factor, connectivity density, and degree of anisotropy. Using a Jamshidi needle®, we obtained samples from three quadrants (QI: right-sided edge, QII: central, QIII: left-sided edge) of 242 prepared vertebrae, and investigated these on a micro-CT device. In all, 726 bone samples were taken from eleven body donors. Bone volume fraction, trabecular thickness, and the degree of anisotropy were significantly lower in QII than in QI and QIII. Trabecular pattern factor, however, was significantly higher in QII than in QI and QIII. The results helped to explain fish vertebrae. Wedge fractures and flat vertebrae are most likely caused by the complex destruction of trabecular and cortical structures. The higher bone volume fraction in the cervical spine compared to the thoracic and lumbar spine accounts for the small number of fractures in the cervical spine. The marked trabecular pattern factor in the center of thoracic and lumbar vertebrae could be a reason for the surgeon to use different screw designs for individual vertebrae.
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Affiliation(s)
- Guido Schröder
- Warnow Clinic, Clinic for Orthopedics and Trauma Surgery, Am Forsthof 3, 18246, Buetzow, Germany.
| | | | - Marko Schulze
- Institute for Anatomy and Cell Biology, University of Bielefeld, Bielefeld, Germany
| | - Laura Hiepe
- Institute for Anatomy, University Medical Center Rostock, Rostock, Germany
| | | | - Heiner Martin
- Institute for Biomedical Engineering, University Medical Center Rostock, Rostock-Warnemuende, Germany
| | - Julian Ramin Andresen
- Clinic for Orthopedic, Trauma and Reconstructive Surgery, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Mario Moritz
- Clinic of Internal Medicine IV, Suedstadt Clinic Rostock, Academic Teaching Hospital of the University of Rostock, Rostock, Germany
| | - Reimer Andresen
- Institute for Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck und Hamburg, Heide, Germany
| | - Hans-Christof Schober
- Clinic of Internal Medicine IV, Suedstadt Clinic Rostock, Academic Teaching Hospital of the University of Rostock, Rostock, Germany
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Schröder G, Denkert K, Hiepe L, Schulze M, Martin H, Andresen JR, Andresen R, Büttner A, Schober HC. Histomorphometric analysis of osteocyte density and trabecular structure of 92 vertebral bodies of different ages and genders. Ann Anat 2023; 246:152022. [PMID: 36403851 DOI: 10.1016/j.aanat.2022.152022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 09/27/2022] [Accepted: 10/25/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Knowledge of the histomorphometric structure of the vertebral body and factors influencing the structure is essential for a fundamental understanding of osteoporosis and osteoporotic fractures. The present study is focused on osteocyte density - a parameter seldom investigated so far - and trabecular width as well as bone area over tissue area in human vertebral bodies. METHODS Ninety-two vertebral body specimens (C5, C6, Th8, Th12, L1, L2) from 12 males and seven females were studied (Ethics Application Number A 2017-0072). The prepared vertebral specimens were extracted from the ventral aspect with a Jamshidi needle®. The punches were decalcified and subsequently H&E stained. Using the Fiji/Image J program (version 1.53 f, Wayne Resband, National Institute of Mental Health, USA), osteocyte numbers were counted per calcified bone surface, and the trabecular width and bone area of trabecular bone were measured. The collected data were analyzed using the statistical software package SPSS, version 23.0 (SPSS Inc., Chicago, USA). Pearson's correlation coefficient was used for correlation analyses. Multiple linear regression analyses were also performed. RESULTS Osteocyte density did not differ significantly in comparisons based on gender and age (≤65 years; ≥66 years). Men had wider trabeculae (p < 0.001) and a higher bone area over tissue area (BA/TA, %) (p = 0.025) than women. Individuals over 65 years of age had thinner trabeculae (p < 0.001) and a smaller BA/TA (%) (p < 0.001) than younger individuals. Multiple linear regression analyses were performed to determine the influence of 'gender' and 'age' on trabecular width and bone area over tissue area. The R² was 0.388 for trabecular width and 0.227 for BA/TA (%). Per year of life, trabecular width decreases by 0.368 µm (β < 0.001) and BA/TA (%) by 0.001% (β = 0.001). Men have on average 8.2 µm wider trabeculae than women (β = 0.035). A negative correlation (r = -0.275) was observed between trabecular width and osteocyte density. The wider the trabeculae, the fewer osteocytes per mm² (p = 0.008). CONCLUSIONS Surprisingly, we found no difference in osteocyte density with reference to age or gender. However, we did register significant age- and gender-related differences in bone area over tissue area and trabecular thickness. The age-related differences were more pronounced, implying that age-dependent loss of bone structure may be more important than differences between genders.
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Affiliation(s)
- Guido Schröder
- Clinic of Orthopedics and Trauma Surgery, Warnow Clinic, Buetzow, Germany.
| | - Kira Denkert
- Medical Faculty, University of Rostock, Rostock, Germany
| | - Laura Hiepe
- Institute for Anatomy, Medical University of Rostock, Rostock, Germany
| | - Marko Schulze
- Institute for Anatomy and Cell Biology, University of Bielefeld, Bielefeld, Germany
| | - Heiner Martin
- Institute for Biomedical Engineering, Medical University of Rostock, Rostock, Germany
| | | | - Reimer Andresen
- Institute of Diagnostic and Interventional Radiology / Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
| | - Andreas Büttner
- Institute of Legal Medicine, Medical University of Rostock, Rostock, Germany
| | - Hans-Christof Schober
- Department of Internal Medicine IV, Municipal Hospital Suedstadt Rostock, Academic Teaching Hospital of the University of Rostock, Rostock, Germany
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Schröder G, Hiepe L, Moritz M, Vivell LM, Schulze M, Martin H, Götz A, Andresen JR, Kullen CM, Andresen R, Schober HC. Why Insufficiency Fractures are Rarely Found in the Cervical Spine, Even with Osteoporosis. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2022; 160:657-669. [PMID: 34937100 DOI: 10.1055/a-1647-3914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The human bone structure changes with an increase in age. Both material and structural properties affect bone strength. Despite the ageing of society, however, hardly any data are available on these parameters for elderly individuals. Therefore, in the present study, cancellous bone cylinders were taken from the center of each vertebral body (C3 to L5) and examined with regard to bone volume fraction, trabecular thickness, separation, number of trabeculae, cross-linking, connectivity density and degree of anisotropy. MATERIAL AND METHODS Samples were obtained from 440 body donors using a Jamshidi needle and analysed using microcomputed tomography. Existing deformities, fractures and bone mineral density of each vertebra were recorded by quantitative computed tomography. RESULTS With regard to the microcomputed tomography parameters, statistically significant differences were found between the different sections of the vertebrae: the trabeculae of the cervical vertebrae were significantly thicker and more closely spaced than in the thoracic and lumbar vertebrae. The bone volume fraction was significantly higher in this spinal segment, as was the connection density and the number of trabeculae and cross-links. In addition, the degree of anisotropy was significantly lower in the cervical vertebrae than in the other spinal segments. With regard to quantitative computed tomography, there was a significantly higher bone mineral density in the cervical vertebrae. CONCLUSION Even with osteoporosis, cervical vertebrae fracture significantly later than thoracic and lumbar vertebrae due to their unique microarchitecture and higher density. Thus, the cervical vertebrae has specific properties.
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Affiliation(s)
- Guido Schröder
- Klinik für Orthopädie und Unfallchirurgie, Warnow Klinik, Bützow, Deutschland
| | - Laura Hiepe
- Institut für Anatomie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Mario Moritz
- Klinik für Innere Medizin, Warnow Klinik, Bützow, Germany
| | | | - Marko Schulze
- Institut für Anatomie und Zellbiologie, Universität Bielefeld, Bielefeld, Deutschland
| | - Heiner Martin
- Institut für Biomedizinische Technik, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Andreas Götz
- Institut für Biomedizinische Technik, Universitätsmedizin Rostock, Rostock, Deutschland
| | | | - Claus-Maximilian Kullen
- Institut für Diagnostische und Interventionelle Radiologie/Neuroradiologie, Westküstenklinikum Heide, Akademisches Lehrkrankenhaus der Universitäten Kiel, Lübeck und Hamburg, Heide, Deutschland
| | - Reimer Andresen
- Institut für Diagnostische und Interventionelle Radiologie/Neuroradiologie, Westküstenklinikum Heide, Akademisches Lehrkrankenhaus der Universitäten Kiel, Lübeck und Hamburg, Heide, Deutschland
| | - Hans-Christof Schober
- Klinik für Innere Medizin IV, Klinikum Südstadt Rostock, Akademisches Lehrkrankenhaus der Universität Rostock, Rostock, Deutschland
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Assessment of Bone Microstructure by Micro CT in C57BL/6J Mice for Sex-Specific Differentiation. Int J Mol Sci 2022; 23:ijms232314585. [PMID: 36498911 PMCID: PMC9735535 DOI: 10.3390/ijms232314585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
It remains uncertain which skeletal sites and parameters should be analyzed in rodent studies evaluating bone health and disease. In this cross-sectional mouse study using micro-computed tomography (µCT), we explored: (1) which microstructural parameters can be used to discriminate female from male bones and (2) whether it is meaningful to evaluate more than one bone site. Microstructural parameters of the trabecular and/or cortical compartments of the femur, tibia, thoracic and lumbar vertebral bodies, and skull were evaluated by µCT in 10 female and 10 male six-month-old C57BL/6J mice. The trabecular number (TbN) was significantly higher, while the trabecular separation (TbSp) was significantly lower in male compared to female mice at all skeletal sites assessed. Overall, bone volume/tissue volume (BV/TV) was also significantly higher in male vs. female mice (except for the thoracic spine, which did not differ by sex). Most parameters of the cortical bone microstructure did not differ between male and female mice. BV/TV, TbN, and TbSp at the femur, and TbN and TbSp at the tibia and lumbar spine could fully (100%) discriminate female from male bones. Cortical thickness (CtTh) at the femur was the best parameter to detect sex differences in the cortical compartment (AUC = 0.914). In 6-month-old C57BL/6J mice, BV/TV, TbN, and TbSp can be used to distinguish male from female bones. Whenever it is not possible to assess multiple bone sites, we propose to evaluate the bone microstructure of the femur for detecting potential sex differences.
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Li R, Zhang W, Xu Y, Ma L, Li Z, Yang D, Ding W. Vertebral endplate defects are associated with bone mineral density in lumbar degenerative disc disease. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:2935-2942. [PMID: 35881201 DOI: 10.1007/s00586-022-07329-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/03/2022] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Evidence has shown that lumbar vertebral endplate defects are clinically relevant and closely related to disc degeneration, but the relationship between endplate defects and bone mineral density (BMD) remains unclear. This study aimed to explore the association between endplate defects and BMD-related values in patients with lumbar degenerative disc disease (LDD). METHODS Three hundred and twenty-five Chinese adult subjects diagnosed with LDD underwent dual energy X-ray absorptiometry. Endplate defects were classified using lumbar MRI. Groups were subdivided based on the occurrence rates of defect endplates. BMD at the lumbar vertebral and bilateral femur necks was compared between groups, and the association between endplate defects and lumbar BMD-related values was analyzed and adjusted for confounders including age, sex, serum levels of 25-hydroxy vitamin D (25(OH)D), calcium (Ca) and phosphorus (P). RESULTS Of 325 patients and 3250 endplates, 59.72% had defects, and 188 patients were divided into the higher defect rate group (occurrence rate > 50%). The higher defect rate group was associated with older age, more common postmenopausal females, higher osteoporosis rates and lower serum Ca and P levels. Lumbar BMD was greater than that at bilateral femur necks and was not equal to osteoporosis diagnosis. Endplate defects were more prevalent in lower segments. The occurrence of endplate defects was positively associated with lumbar BMD-related values in the partial correlation analysis. The association between endplate defects and lumbar BMD varies for subtypes and segments, with a trend of positive association in rim and erosive subtypes after adjusting for confounders. CONCLUSIONS The present study demonstrated that the occurrence of endplate defects was associated with greater lumbar BMD values in patients with LDD. This association varies for different defect subtypes and segments. The results indicated that endplate defects should be taken into consideration in osteoporosis treatment to alleviate disc degeneration.
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Affiliation(s)
- Ruoyu Li
- Department of Spine Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China
| | - Wei Zhang
- Department of Spine Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China
| | - Yafei Xu
- Department of Spine Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China
| | - Lei Ma
- Department of Spine Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China
| | - Zhaohui Li
- Department of Spine Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China
| | - Dalong Yang
- Department of Spine Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China
| | - Wenyuan Ding
- Department of Spine Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.
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Medial tibial plateau sustaining higher physiological stress than the lateral plateau: based on 3D printing and finite element method. Biomed Eng Online 2022; 21:68. [PMID: 36114576 PMCID: PMC9482229 DOI: 10.1186/s12938-022-01039-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 09/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Medial compartment knee osteoarthritis (KOA) accounts for most KOA cases, and increased trabecular bone volume fraction (BV/TV) is one of the pathological changes in the tibial plateau of KOA. How BV/TV changes before and after the menopause and its effects on medial compartment KOA are yet to be clarified. Methods Twenty femurs from twenty 12-week-old rats were included. The operated group underwent ovariectomy (to represent the osteoporosis condition), called the O group, and the non-operated group was the normal control, called the N group. Micro-CT scans of the femoral condyles were acquired 12 weeks after the surgery, and the volume of interest (VOI) of medial-, inter-, and lateral-condyle trabeculae were three-dimensional (3D) printed for uniaxial compression mechanical test and simulated by the finite element (FE) method. Results The results demonstrated that the O group indicated poorer trabecular architecture than the N group in three parts of the femoral condyle, especially in the intercondyle. Within the group, the BV/TV, trabecular thickness (Tb.Th), and trabecular number (Tb.N) ratios between the medial and lateral condyles were greater than 1 in both N and O groups. The medial condyle trabeculae's mechanical properties were higher than those of the lateral condyle, and this superiority appears to be broadened under osteoporotic conditions. FE modelling well reproduced these mechanical differentiations. Conclusions According to Wolff's law, the higher BV/TV and mechanical properties of the medial femoral condyle may be due to inherent imbalanced loading on the knee component. Alterations in BV/TV and their corresponding mechanical properties may accompany KOA.
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Xiong Y, Zhang Y, Zhou F, Liu Y, Yi Z, Gong P, Wu Y. FOXO1 differentially regulates bone formation in young and aged mice. Cell Signal 2022; 99:110438. [PMID: 35981656 DOI: 10.1016/j.cellsig.2022.110438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/07/2022] [Accepted: 08/10/2022] [Indexed: 11/03/2022]
Abstract
It is a great challenge to develop a safe and effective treatment strategy for age-related osteoporosis and fracture healing. As one of the four FOXO transcription factors, FOXO1 is essential for cell proliferation, survival, senescence, energy metabolism, and oxidative stress in various cells. Our previous study demonstrated that specific Foxo1 gene deletion in osteoblasts in young mice results in bone loss while that in aged mice shows the opposite effect. However, the mechanism underlying the differential regulation of bone metabolism by FOXO1 remains to be elucidated. In this study, we generated osteoblast-specific Foxo1 knockout mice by using Foxo1fl/fl and Bglap-Cre mice. In young mice, Foxo1 gene deletion inhibits osteoblast differentiation, leading to a decreased osteoblast number and decreased bone formation rate because of the weakened ability to resist oxidative stress, eventually resulting in bone loss and delayed healing of bone defects. In aged mice, high levels of reactive oxygen species (ROS) promote the diversion of CTNNB1 (β-catenin) from T cell factor 4 (TCF4)- to FOXO1-mediated transcription, thereby inhibiting Wnt/β-catenin signaling and leading to decreased osteogenic activity. Conversely, FOXO1 deficiency indirectly promotes the binding of β-catenin and TCF4 and activates Wnt/β-catenin signaling, thereby alleviating age-related bone loss and improving bone defect healing. Our study proves that FOXO1 has differential effects on bone metabolism in young and aged mice and elucidates its underlying mechanism. Further, this study provides a new perspective on the treatment of age-related osteoporosis.
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Affiliation(s)
- Yi Xiong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yixin Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Feng Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yeyu Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zumu Yi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ping Gong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yingying Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Lamarche BA, Thomsen JS, Andreasen CM, Lievers WB, Andersen TL. 2D size of trabecular bone structure units (BSU) correlate more strongly with 3D architectural parameters than age in human vertebrae. Bone 2022; 160:116399. [PMID: 35364343 DOI: 10.1016/j.bone.2022.116399] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/14/2022] [Accepted: 03/25/2022] [Indexed: 11/22/2022]
Abstract
Bone tissue is continuously remodeled. In trabecular bone, each remodeling transaction forms a microscopic bone structural unit (BSU), also known as a hemiosteon or a trabecular packet, which is bonded to existing tissue by osteopontin-rich cement lines. The size and shape of the BSUs are determined by the size and shape of the resorption cavity, and whether the cavity is potentially over- or under-filled by the subsequent bone formation. The present study focuses on the recently formed trabecular BSUs, and how their 2D size and shape changes with age and trabecular microstructure. The study was performed using osteopontin-immunostained frontal sections of L2 vertebrae from 8 young (aged 18.5-37.6 years) and 8 old (aged 69.1-96.4 years) control females, which underwent microcomputed tomography (μCT) imaging prior to sectioning. The contour of 4230 BSU profiles (181-385 per vertebra) within 1024 trabecular profiles were outlined, and their 2D width, length, area, and shape were assessed. Of these BSUs, 22 (0.5%) were generated by modeling-based bone formation (i.e. without prior resorption), while 99.5% were generated by remodeling-based bone formation (i.e. with prior resorption). The distributions of BSU profile width, length, and area were significantly smaller in the old versus young females (p < 0.005), and the median profile width, length, and area were negative correlated with age (p < 0.018). Importantly, these BSU profile size parameters were more strongly correlated with trabecular bone volume (BV/TV, p < 0.002) and structure model index (SMI, p < 0.008) assessed by μCT, than age. Moreover, the 2D BSU size parameters were positively correlated to the area of the individual trabecular profiles (p < 0.0001), which were significantly smaller in the old versus young females (p < 0.024). The BSU shape parameters (aspect ratio, circularity, and solidity) were not correlated with age, BV/TV, or SMI. Collectively, the study supports the notion that not only the BSU profile width, but also its length and area, are more influenced by the age-related bone loss and shift from plates to rods (SMI), than age itself. This implies that BSU profile size is mainly driven by changes in the trabecular microstructure, which affect the size of the resorption cavity that the BSU refills.
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Affiliation(s)
- Britney Alexi Lamarche
- Bharti School of Engineering and Computer Science, Laurentian University, Sudbury, Ontario, Canada
| | | | - Christina Møller Andreasen
- Clinical Cell Biology, Dept. of Pathology, Odense University Hospital, Odense, Denmark; Pathology Research Unit, Dept. of Molecular Medicine & Dept. of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - W Brent Lievers
- Bharti School of Engineering and Computer Science, Laurentian University, Sudbury, Ontario, Canada.
| | - Thomas Levin Andersen
- Clinical Cell Biology, Dept. of Pathology, Odense University Hospital, Odense, Denmark; Pathology Research Unit, Dept. of Molecular Medicine & Dept. of Clinical Research, University of Southern Denmark, Odense, Denmark; Dept. of Forensic Medicine, Aarhus University, Aarhus, Denmark.
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Malatong Y, Palee P, Sinthubua A, Na Lampang S, Mahakkanukrauh P. Estimating age from digital radiographic images of lumbar vertebrae in a Thai population using an image analysis technique. MEDICINE, SCIENCE, AND THE LAW 2022; 62:180-187. [PMID: 34821164 DOI: 10.1177/00258024211062027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Using the lumbar vertebra for age estimation is helpful in cases when skeletal remains are incomplete and typical skeletal age indicators are absent. This study aimed to apply an image analysis method in extracting black pixel variables for age estimation by using the radiographic images of lumbar vertebra in a Thai population. All lumbar vertebrae L1-L5 of 220 (110 males and 110 females) from Thai individuals of known sex and ages were studied. The variables of Total Percentage of black pixels (TP), Mean Percentage of black pixels (MP), and Ratio of black to white pixels (BW), were calculated to assess the relationship between black pixel variables and aging. Equations were formulated using linear regression analysis. The results of this study indicated three variables of the lumbar vertebrae had significantly positive correlations with age. The correlation between parameters with age in males ranged 0.211-0.419, while the range in females was 0.219-0.458. The appropriate linear regression equation with the total and mean percentages of black pixel variables shows Age = -1.348+0.871 (TP) +0.514 (MP) of L4 for males (SEE; 15.4 years), and Age = 5.338 +0.316 (TP) +0.952 (MP) of L1 for females (SEE; 13.8 years). Age estimation using an image analysis method is an alternative to investigating the trabecular structure. The black pixel variable is not the actual value of bone density. However, it is useful to study its relationship with aging.
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Affiliation(s)
- Yanumart Malatong
- Department of Anatomy, Faculty of Medicine, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Patison Palee
- College of Arts, Media and Technology, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Apichat Sinthubua
- Department of Anatomy, Faculty of Medicine, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Sakarat Na Lampang
- Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, 26682Chiang Mai University, Chiang Mai, Thailand
| | - Pasuk Mahakkanukrauh
- Department of Anatomy, Faculty of Medicine, 26682Chiang Mai University, Chiang Mai, Thailand
- Forensic Osteology Research Center (FORC), Faculty of Medicine, 26682Chiang Mai University, Chiang Mai, Thailand
- Excellence in Osteology Research and Training Center (ORTC), 26682Chiang Mai University, Chiang Mai, Thailand
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Öhman‐Mägi C, Holub O, Wu D, Hall RM, Persson C. Density and mechanical properties of vertebral trabecular bone-A review. JOR Spine 2021; 4:e1176. [PMID: 35005442 PMCID: PMC8717096 DOI: 10.1002/jsp2.1176] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 10/14/2021] [Accepted: 10/20/2021] [Indexed: 11/16/2022] Open
Abstract
Being able to predict the mechanical properties of vertebrae in patients with osteoporosis and other relevant pathologies is essential to prevent fractures and to develop the most favorable fracture treatments. Furthermore, a reliable prediction is important for developing more patient- and pathology-specific biomaterials. A plethora of studies correlating bone density to mechanical properties has been reported; however, the results are variable, due to a variety of factors, including anatomical site and methodological differences. The aim of this study was to provide a comprehensive literature review on density and mechanical properties of human vertebral trabecular bone as well as relationships found between these properties. A literature search was performed to include studies, which investigated mechanical properties and bone density of trabecular bone. Only studies on vertebral trabecular bone tissue, reporting bone density or mechanical properties, were kept. A large variation in reported vertebral trabecular bone densities, mechanical properties, and relationships between the two was found, as exemplified by values varying between 0.09 and 0.35 g/cm3 for the wet apparent density and from 0.1 to 976 MPa for the elastic modulus. The differences were found to reflect variations in experimental and analytical processes that had been used, including testing protocol and specimen geometry. The variability in the data decreased in studies where bone tissue testing occurred in a standardized manner (eg, the reported differences in average elastic modulus decreased from 400% to 10%). It is important to take this variability into account when analyzing the predictions found in the literature, for example, to calculate fracture risk, and it is recommended to use the models suggested in the present review to reduce data variability.
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Affiliation(s)
- Caroline Öhman‐Mägi
- Department of Materials Science and EngineeringUppsala UniversityUppsalaSweden
| | - Ondrej Holub
- School of Mechanical EngineeringUniversity of LeedsLeedsUK
| | - Dan Wu
- Department of Materials Science and EngineeringUppsala UniversityUppsalaSweden
| | | | - Cecilia Persson
- Department of Materials Science and EngineeringUppsala UniversityUppsalaSweden
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Degteva MO, Tolstykh EI, Shishkina EA, Sharagin PA, Zalyapin VI, Volchkova AY, Smith MA, Napier BA. Stochastic parametric skeletal dosimetry model for humans: General approach and application to active marrow exposure from bone-seeking beta-particle emitters. PLoS One 2021; 16:e0257605. [PMID: 34648511 PMCID: PMC8516275 DOI: 10.1371/journal.pone.0257605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 09/05/2021] [Indexed: 11/25/2022] Open
Abstract
The objective of this study is to develop a skeleton model for assessing active marrow dose from bone-seeking beta-emitting radionuclides. This article explains the modeling methodology which accounts for individual variability of the macro- and microstructure of bone tissue. Bone sites with active hematopoiesis are assessed by dividing them into small segments described by simple geometric shapes. Spongiosa, which fills the segments, is modeled as an isotropic three-dimensional grid (framework) of rod-like trabeculae that “run through” the bone marrow. Randomized multiple framework deformations are simulated by changing the positions of the grid nodes and the thickness of the rods. Model grid parameters are selected in accordance with the parameters of spongiosa microstructures taken from the published papers. Stochastic modeling of radiation transport in heterogeneous media simulating the distribution of bone tissue and marrow in each of the segments is performed by Monte Carlo methods. Model output for the human femur at different ages is provided as an example. The uncertainty of dosimetric characteristics associated with individual variability of bone structure was evaluated. An advantage of this methodology for the calculation of doses absorbed in the marrow from bone-seeking radionuclides is that it does not require additional studies of autopsy material. The biokinetic model results will be used in the future to calculate individual doses to members of a cohort exposed to 89,90Sr from liquid radioactive waste discharged to the Techa River by the Mayak Production Association in 1949–1956. Further study of these unique cohorts provides an opportunity to gain more in-depth knowledge about the effects of chronic radiation on the hematopoietic system. In addition, the proposed model can be used to assess the doses to active marrow under any other scenarios of 90Sr and 89Sr intake to humans.
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Affiliation(s)
| | | | - Elena A. Shishkina
- Urals Research Center for Radiation Medicine, Chelyabinsk, Russia
- Chelyabinsk State University, Chelyabinsk, Russia
| | | | | | | | - Michael A. Smith
- Pacific Northwest National Laboratory, Richland, Washington, United States of America
| | - Bruce A. Napier
- Pacific Northwest National Laboratory, Richland, Washington, United States of America
- * E-mail:
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Chuang TL, Chuang MH, Wang YF, Koo M. Age-Specific Normative Values of Lumbar Spine Trabecular Bone Score (TBS) in Taiwanese Men and Women. J Clin Med 2021; 10:jcm10204740. [PMID: 34682863 PMCID: PMC8537042 DOI: 10.3390/jcm10204740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022] Open
Abstract
Trabecular bone score (TBS) is a novel method for assessing trabecular microarchitecture. Normative values of TBS are available for various populations of the world but are not yet available for Taiwanese adults. Therefore, the purpose of this study was to estimate age-specific, normative TBS curves for Taiwanese men and women. Medical records of general health examinations from a regional hospital in Southern Taiwan were reviewed. Individuals aged 30–90 years with data on lumbar spine bone mineral density (BMD) were included. TBS was retrospectively calculated from dual-energy X-ray absorptiometry scans using TBS iNsight software. Of the 12,028 patients included, 4533 (37.7%) were male and the mean age was 55.8 years. The mean TBS was 1.392 (standard deviation (SD) 0.089) for men and 1.344 (SD 0.107) for women. In women, TBS declined at a rate of 0.0004/year among those aged 30.0–45.9 years, 0.0106/year among those 46.0–60.7 years, and 0.0028/year among those 60.8–90.0 years. In men, TBS declined at a constant rate of 0.0023/year over the entire age range. In conclusion, age-adjusted, normative curves of TBS for Taiwanese men and women are presented, which could be used to facilitate the use of TBS in assessing bone status in clinical practice.
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Affiliation(s)
- Tzyy-Ling Chuang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi 622401, Taiwan; (T.-L.C.); (Y.-F.W.)
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan;
| | - Mei-Hua Chuang
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan;
- Faculty of Pharmacy, National Yang-Ming Chiao Tung University, Taipei City 112304, Taiwan
- MacKay Junior College of Medicine, Nursing and Management, New Taipei City 112021, Taiwan
| | - Yuh-Feng Wang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi 622401, Taiwan; (T.-L.C.); (Y.-F.W.)
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan;
- Center of Preventive Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi 622401, Taiwan
| | - Malcolm Koo
- Graduate Institute of Long-Term Care, Tzu Chi University of Science and Technology, Hualien 970302, Taiwan
- Correspondence: ; Tel.: +886-3-857-2158 (ext. 2206)
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20
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Schröder G, Jabke B, Schulze M, Wree A, Martin H, Sahmel O, Doerell A, Kullen CM, Andresen R, Schober HC. A comparison, using X-ray micro-computed tomography, of the architecture of cancellous bone from the cervical, thoracic and lumbar spine using 240 vertebral bodies from 10 body donors. Anat Cell Biol 2021; 54:25-34. [PMID: 33583827 PMCID: PMC8017461 DOI: 10.5115/acb.20.269] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/06/2020] [Accepted: 12/07/2020] [Indexed: 11/29/2022] Open
Abstract
The vertebral trabecular bone has a complex three-dimensional microstructure with an inhomogeneous morphology. Correct identification and assessment of the weakest segments of the cancellous bone may lead to better prediction of fracture risk. The aim of this study was to compare cancellous bone from 240 vertebrae of the cervical, thoracic and lumbar spine of ten body donors with osteoporosis in regard to bone volume fraction (BVF), trabecular thickness, separation, trabecular number and degree of anisotropy, to ascertain why cervical vertebrae rarely fracture, even with severe osteoporosis. Samples were obtained from all vertebrae with a Jamshidi needle (8 Gauge). The investigations were performed with a micro-computed tomography (micro-CT) device (SKYSCAN 1172, RJL Micro & Analytic GmbH, Karlsdorf-Neuthard, Germany). Existing vertebral fractures and the bone mineral density of the lumbar spine were assessed with quantitative CT. Regarding the micro-CT parameters, statistically significant differences were observed between the various sections of the spine. We found a higher BVF, trabecular number and trabecular thickness, as well as a lower trabecular separation of the cervical vertebrae compared to other vertebrae. In addition, the degree of anisotropy in the cervical spine is lower than in the other spinal column sections. These results are age and sex dependent. Thus, the cervical spine has special structural features, whose causes must be determined in further investigations.
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Affiliation(s)
- Guido Schröder
- Clinic for Surgery, Department of Orthopedics and Trauma Surgery, Buetzow, Germany
| | - Benjamin Jabke
- Department of Internal Medicine, University Medical School Rostock, Rostock, Germany
| | - Marko Schulze
- Institute of Anatomy, University Medical School Rostock, Rostock, Germany
| | - Andreas Wree
- Institute of Anatomy, University Medical School Rostock, Rostock, Germany
| | - Heiner Martin
- Institute for Biomedical Engineering, University of Rostock, Rostock-Warnemuende, Germany
| | - Olga Sahmel
- Institute for Biomedical Engineering, University of Rostock, Rostock-Warnemuende, Germany
| | | | - Claus Maximilian Kullen
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
| | - Reimer Andresen
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
| | - Hans-Christof Schober
- Department of Internal Medicine IV, Municipal Hospital Suedstadt Rostock, Academic Teaching Hospital of the University of Rostock, Rostock, Germany
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21
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Cheng YH, Liu SF, Dong JC, Bian Q. Transcriptomic alterations underline aging of osteogenic bone marrow stromal cells. World J Stem Cells 2021; 13:128-138. [PMID: 33584984 PMCID: PMC7859986 DOI: 10.4252/wjsc.v13.i1.128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/01/2020] [Accepted: 11/17/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Multipotent bone marrow stromal cells (BMSCs) are adult stem cells that form functional osteoblasts and play a critical role in bone remodeling. During aging, an increase in bone loss and reduction in structural integrity lead to osteoporosis and result in an increased risk of fracture. We examined age-dependent histological changes in murine vertebrae and uncovered that bone loss begins as early as the age of 1 mo.
AIM To identify the functional alterations and transcriptomic dynamics of BMSCs during early bone loss.
METHODS We collected BMSCs from mice at early to middle ages and compared their self-renewal and differentiation potential. Subsequently, we obtained the transcriptomic profiles of BMSCs at 1 mo, 3 mo, and 7 mo.
RESULTS The colony-forming and osteogenic commitment capacity showed a comparable finding that decreased at the age of 1 mo. The transcriptomic analysis showed the enrichment of osteoblastic regulation genes at 1 mo and loss of osteogenic features at 3 mo. The BMSCs at 7 mo showed enrichment of adipogenic and DNA repair features. Moreover, we demonstrated that the WNT and MAPK signaling pathways were upregulated at 1 mo, followed by increased pro-inflammatory and apoptotic features.
CONCLUSION Our study uncovered the cellular and molecular dynamics of bone aging in mice and demonstrated the contribution of BMSCs to the early stage of age-related bone loss.
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Affiliation(s)
- Yu-Hao Cheng
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States
| | - Shu-Fen Liu
- Institute of Spine, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, China
| | - Jing-Cheng Dong
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Qin Bian
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
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22
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Marage L, Gambarota G, Lasbleiz J, Lederlin M, Saint-Jalmes H. Confounding factors in multi-parametric q-MRI protocol: A study of bone marrow biomarkers at 1.5 T. Magn Reson Imaging 2020; 74:96-104. [PMID: 32858181 DOI: 10.1016/j.mri.2020.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 07/23/2020] [Accepted: 08/20/2020] [Indexed: 10/23/2022]
Abstract
OBJECT The MRI tissue characterization of vertebral bone marrow includes the measurement of proton density fat fraction (PDFF), T1 and T2* relaxation times of the water and fat components (T1W, T1F, T2*W, T2*F), IVIM diffusion D, perfusion fraction f and pseudo-diffusion coefficient D*. However, the measurement of these vertebral bone marrow biomarkers (VBMBs) is affected with several confounding factors. In the current study, we investigated these confounding factors including the regional variation taking the example of variation between the anterior and posterior area in lumbar vertebrae, B1 inhomogeneity and the effect of fat suppression on f. MATERIALS AND METHODS A fat suppressed diffusion-weighted sequence and two 3D gradient multi-echo sequences were used for the measurements of the seven VBMBs. A turbo flash B1 map sequence was used to estimate B1 inhomogeneities and thus, to correct flip angle for T1 quantification. We introduced a correction to perfusion fraction f measured with fat suppression, namely fPDFF. RESULTS A significant difference in the values of PDFF, f and fPDFF, T1F, T2*W and D was observed between the anterior and posterior region. Although, little variations of flip angle were observed in this anterior-posterior direction in one vertebra but larger variations were observed in head-feet direction from L1 to L5 vertebrae. DISCUSSION The regional difference in PDFF, fPDFF and T2*W can be ascribed to differences in the trabecular bone density and vascular network within vertebrae. The regional variation of VBMBs shows that care should be taken in reproducing the same region-of-interest location along a longitudinal study. The same attention should be taken while measuring f in fatty environment, and measuring T1. Furthermore, the MRI-protocol presented here allows for measurements of seven VBMBs in less than 6 min and is of interest for longitudinal studies of bone marrow diseases.
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Affiliation(s)
- Louis Marage
- Univ Rennes, CHU Rennes, CLCC Eugène Marquis, Inserm, LTSI - UMR 1099, F-35000 Rennes, France.
| | - Giulio Gambarota
- Univ Rennes, CHU Rennes, CLCC Eugène Marquis, Inserm, LTSI - UMR 1099, F-35000 Rennes, France
| | - Jeremy Lasbleiz
- Univ Rennes, CHU Rennes, CLCC Eugène Marquis, Inserm, LTSI - UMR 1099, F-35000 Rennes, France
| | - Mathieu Lederlin
- Univ Rennes, CHU Rennes, CLCC Eugène Marquis, Inserm, LTSI - UMR 1099, F-35000 Rennes, France
| | - Hervé Saint-Jalmes
- Univ Rennes, CHU Rennes, CLCC Eugène Marquis, Inserm, LTSI - UMR 1099, F-35000 Rennes, France
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23
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McKay M, Jackman TM, Hussein AI, Guermazi A, Liu J, Morgan EF. Association of vertebral endplate microstructure with bone strength in men and women. Bone 2020; 131:115147. [PMID: 31706053 PMCID: PMC6930346 DOI: 10.1016/j.bone.2019.115147] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/23/2019] [Accepted: 11/05/2019] [Indexed: 11/26/2022]
Abstract
Epidemiological and biomechanical evidence indicates that the risk of vertebral fracture differs between men and women, and that vertebral fracture frequently involves failure of the endplate region. The goal of this study was to compare the bone microstructure of the endplate region-defined as the (bony) vertebral endplate and underlying subchondral trabecular bone-between sexes and to determine whether any such sex differences are associated with vertebral strength. The bone density (volume fraction, apparent density and tissue mineral density) of the superior-most 2 mm of the vertebra, and the bone density and trabecular architecture of the next 5 mm were quantified using micro-computed tomography in human T8 (12 female, 16 male) and L1 (13 female, 12 male) vertebrae. Average density of the vertebra (integral bone mineral density (BMD)) was determined by quantitative computed tomography and compressive strength by mechanical testing. Few differences were found between male and female vertebrae in the density of the endplate region; none were found in trabecular architecture. However, whereas endplate volume fraction was positively correlated with integral BMD in male vertebrae (r = 0.654, p < .001), no correlation was found in the female vertebrae (r = 0.157, p = .455). Accounting for the density of the endplate region improved predictions of vertebral strength (p < .034) and eliminated sex-specificity in the strength prediction that was based on integral BMD alone. These results suggest that the density of the endplate region influences vertebral fracture and that non-invasive assessment of this region's density can contribute to predictions of vertebral strength in men and women.
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Affiliation(s)
- MeiLissa McKay
- Department of Mechanical Engineering, 110 Cummington Mall, Boston University, Boston, MA 02215, USA
| | - Timothy M Jackman
- Department of Mechanical Engineering, 110 Cummington Mall, Boston University, Boston, MA 02215, USA
| | - Amira I Hussein
- Department of Mechanical Engineering, 110 Cummington Mall, Boston University, Boston, MA 02215, USA
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA 02118, USA
| | - Jingjiang Liu
- Department of Mechanical Engineering, 110 Cummington Mall, Boston University, Boston, MA 02215, USA
| | - Elise F Morgan
- Department of Mechanical Engineering, 110 Cummington Mall, Boston University, Boston, MA 02215, USA.
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McGivern H, Greenwood C, Márquez-Grant N, Kranioti EF, Xhemali B, Zioupos P. Age-Related Trends in the Trabecular Micro-Architecture of the Medial Clavicle: Is It of Use in Forensic Science? Front Bioeng Biotechnol 2020; 7:467. [PMID: 32039176 PMCID: PMC6988573 DOI: 10.3389/fbioe.2019.00467] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/19/2019] [Indexed: 12/02/2022] Open
Abstract
The mechanical and structural properties of bone are known to change significantly with age. Within forensic and archaeological investigations, the medial end of the clavicle is typically used for estimating the age-at-death of an unknown individual. Although, this region of the skeleton is of interest to forensic and clinical domains, alterations beyond the macro-scale have not been fully explored. For this study, non-destructive micro-computed tomography (μ-CT) was employed to characterize structural alterations to the cancellous bone of the medial clavicle. Fresh human cadaveric specimens (12-59 years) obtained at autopsy were utilized for this study, and were scanned with a voxel size of ~83 μm. Morphometric properties were quantified and indicated that the bone volume, connectivity density, mineral density, and number of trabeculae decreased with age, while the spacing between the trabeculae increased with age. In contrast to other sub-regions of the skeleton, trabecular thickness, and degree of anisotropy did not correlate with age. Collectively, this could suggest that the network is becoming increasingly perforated with age rather than exhibiting trabecular thinning. These results are used in the context of deriving a potential protocol for forensic investigations by using this particular and largely unexplored region of the skeleton, and provide inspiration for future experiments concerning micro-architectural and small scale changes in other regions of the human skeleton.
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Affiliation(s)
- Hannah McGivern
- Cranfield Forensic Institute, Cranfield University, Defence Academy of the United Kingdom, Shrivenham, United Kingdom
| | - Charlene Greenwood
- School of Chemistry and Physical Sciences, Keele University, Keele, United Kingdom
| | - Nicholas Márquez-Grant
- Cranfield Forensic Institute, Cranfield University, Defence Academy of the United Kingdom, Shrivenham, United Kingdom
| | - Elena F. Kranioti
- Edinburgh Unit for Forensic Anthropology, School of History Classics and Archaeology, University of Edinburgh, Edinburgh, United Kingdom
- Forensic Medicine Unit, Department of Forensic Sciences, Faculty of Medicine, University of Crete, Heraklion, Greece
| | | | - Peter Zioupos
- Cranfield Forensic Institute, Cranfield University, Defence Academy of the United Kingdom, Shrivenham, United Kingdom
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25
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Vom Scheidt A, Hemmatian H, Püschel K, Krause M, Amling M, Busse B. Bisphosphonate treatment changes regional distribution of trabecular microstructure in human lumbar vertebrae. Bone 2019; 127:482-487. [PMID: 31280018 DOI: 10.1016/j.bone.2019.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 06/20/2019] [Accepted: 07/03/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND In osteoporosis patients, antiresorptive treatments such as alendronate reduce the resorption of trabecular bone and thus minimize vertebral fracture risk. However, fracture risk reduction efficacy of antiresorptive drugs varies between skeletal sites and is highest for vertebral bone. In human vertebrae, cancellous bone is distributed heterogeneously between regions. This microstructural heterogeneity is changing with patient age and is likely to play a major role in vertebral failure mechanisms and fracture susceptibility. Whether antiresorptive treatment affects the heterogeneity of vertebral microstructure in osteoporosis has not been unraveled. METHODS Our aim was to assess whether antiresorptive treatment would have a region-dependent influence on vertebral trabecular bone. Therefore, we used high-resolution peripheral quantitative computed tomography (HR-pQCT), microcomputed tomography (microCT) and uniaxial compression testing to determine the structure and mechanical properties of trabecular bone cores from anterior and posterior regions of 22 lumbar vertebrae from elderly osteoporotic women. We analyzed age-matched ex vivo bone samples from bisphosphonate-treated female osteoporosis patients (age: 82 ± 7y, bisphosphonate treatment period: 4 ± 2 years) along treatment-naïve female controls (82 ± 7y). RESULTS MicroCT analysis showed a significantly lower bone volume fraction (p = 0.006) and lower trabecular number (p = 0.003) for the anterior bone cores compared to posterior bone cores in the treatment-naïve group. The bisphosphonate-treated group had a more homogeneous bone volume distribution and did not show significant regional differences in bone volume, it however also displayed significantly different trabecular numbers (p = 0.016). In bone cores of the bisphosphonate-treated group, trabeculae were thicker in comparison to treatment-naïve controls (p = 0.011). Differences in bone volume further resulted in different maximum forces during compression testing between the samples. In addition, the percental difference between BV/TVμCT in anterior and posterior bone cores was lower in bisphosphonate-treated vertebrae when vertebrae with directly adjacent fractures (n = 3) were excluded. CONCLUSION In conclusion, regional trabecular bone microstructure in lumbar vertebrae of bisphosphonate-treated women was more homogeneous compared to treatment-naïve controls. Bisphosphonate treatment, which specifically targets resorption surfaces common in anterior vertebral bone, might have resulted in a region-specific preservation of vertebral microstructure and loading capacity. This could have positive implications for the reduction of wedge fracture risk and add to the explanation of the higher efficacy of fracture risk reduction in vertebrae in comparison to other fracture regions.
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Affiliation(s)
- Annika Vom Scheidt
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55A, 22529 Hamburg, Germany.
| | - Haniyeh Hemmatian
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55A, 22529 Hamburg, Germany.
| | - Klaus Püschel
- Department of Forensic Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Germany.
| | - Matthias Krause
- Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55A, 22529 Hamburg, Germany.
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55A, 22529 Hamburg, Germany.
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Stinchfield T, Vadapalli S, Pennington Z, Sivagnanam R, Prevost J, Schroeder G, Sciubba DM. Improvement in vertebral endplate engagement following anterior column reconstruction using a novel expandable cage with self-adjusting, multiaxial end cap. J Clin Neurosci 2019; 67:249-254. [DOI: 10.1016/j.jocn.2019.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/09/2019] [Indexed: 10/26/2022]
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Hollensteiner M, Esterer B, Fürst D, Schrempf A, Augat P. Development of open-cell polyurethane-based bone surrogates for biomechanical testing of pedicle screws. J Mech Behav Biomed Mater 2019; 97:247-253. [DOI: 10.1016/j.jmbbm.2019.05.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/14/2019] [Accepted: 05/14/2019] [Indexed: 11/29/2022]
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28
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Vom Scheidt A, Grisolia Seifert EF, Pokrant C, Püschel K, Amling M, Busse B, Milovanovic P. Subregional areal bone mineral density (aBMD) is a better predictor of heterogeneity in trabecular microstructure of vertebrae in young and aged women than subregional trabecular bone score (TBS). Bone 2019; 122:156-165. [PMID: 30776500 DOI: 10.1016/j.bone.2019.02.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/11/2019] [Accepted: 02/13/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Currently, bone densitometry fails to identify nearly half of those elderly patients at immediate fracture risk. To improve clinical assessment of vertebral fracture risk, we aimed to determine how the DXA-based 2D parameter Trabecular Bone Score (TBS) relates to subregional variability in 3D trabecular microstructure in young and elderly women compared to aBMD. METHODS T12 vertebrae from 29 women (11 young: 32 ± 6 years, 18 aged: 71 ± 5 years) were DXA-scanned ex vivo in anterior-posterior (AP) and lateral projection providing vertebral aBMD and TBS. Additionally, aBMD and TBS were measured for three horizontal (superior, mid-horizontal, inferior) and three vertical subregions (anterior, mid-vertical, posterior) and related to 3D microstructure indices, i.e. bone volume per tissue volume (BV/TV), trabecular number and thickness (Tb.N, Tb.Th), based on HRpQCT. RESULTS Subregional high-resolution tomography showed significant differences in trabecular parameters for both age groups: In horizontal subregions, BV/TV was lowest superiorly, Tb.Th was highest mid-horizontally, and Tb.N was lowest mid-horizontally and highest inferiorly. Correspondingly, aBMD varied between horizontal subregions, with differences depending on projection direction. TBS varied only in lateral projections of the aged group, with lower values for the mid-horizontal subregion. In vertical subregions, BV/TV, Tb.N, and aBMD were highest posteriorly for both groups. TBS did not differ between vertical subregions. Regression analysis showed aBMD as a predictor explained more of the variance in subregional 3D microstructure compared to TBS. Stepwise multi-regression analysis revealed only three combinations of subregion, projection, and group where aBMD and TBS were both significant predictors. CONCLUSIONS Subregional aBMD reflects variations in trabecular bone microstructure better than subregional TBS for trisected regions. Specifically, lateral aBMD identifies microstructural heterogeneities independent of age and may improve prediction of vertebral strength and susceptibility to specific fracture types.
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Affiliation(s)
- Annika Vom Scheidt
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Germany
| | | | - Carolin Pokrant
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Germany
| | - Klaus Püschel
- Department of Forensic Medicine, University Medical Center Hamburg-Eppendorf, Germany
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Germany
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Germany.
| | - Petar Milovanovic
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Germany; Laboratory for Anthropology and Skeletal Biology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, Serbia
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Normal trabecular vertebral bone is formed via rapid transformation of mineralized spicules: A high-resolution 3D ex-vivo murine study. Acta Biomater 2019; 86:429-440. [PMID: 30605771 DOI: 10.1016/j.actbio.2018.12.050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 12/01/2018] [Accepted: 12/30/2018] [Indexed: 12/13/2022]
Abstract
At birth, mouse vertebrae have a reticular fine spongy morphology, yet in the adult animal they exhibit elaborate trabecular architectures. Here, we characterize the physiological microstructural transformations in growing young female mice of the widely used C57BL/6 strain. Extensive architectural changes lead to the establishment of mature cancellous bone in the spine. Vertebrae were mapped in 3D by high resolution microcomputed tomography (µCT), backed by conventional histology. Three different phases are observed in the natural bony biomaterial: In a prenatal templating phase, early vertebrae are composed of foamy, loosely-packed mineralized spicules. During a consolidation phase in the first 7 days after birth, bone material condenses into struts and forms primitive trabeculae accompanied by a significant (>50%) reduction in bone volume/tissue volume ratio (BV/TV). After day 7, the trabeculae expand, reorient and increase in mineral density. Swift growth ensues such that by day 14 the young lumbar spine exhibits all morphological features observed in the mature animal. The greatly varied micro-morphologies of normal trabecular bone observed in 3D within a short timespan are typical for rodent and presumably for other mammalian forming spines. This suggests that fully structured cancellous bone emerges through rapid post-natal restructuring of a foamy mineralized scaffold. STATEMENT OF SIGNIFICANCE: Cancellous bone develops in stages that are not well documented. Using a mouse model, we provide an observer-independent quantification of normal bone formation in the spine. We find that within 14 days, the cancellous bone transforms in 3 phases from a scaffold of spicules into well organized, fully mineralized trabeculae in a functional spine. Detailed knowledge of the physiological restructuring of mineralized material may help to better understand bone formation and may serve as a blueprint for studies of pharmaceuticals effects, tissue healing and regeneration.
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30
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Disc degeneration promotes regional inhomogeneity in the trabecular morphology of loaded rat tail vertebrae. J Orthop Translat 2018; 15:104-111. [PMID: 30564552 PMCID: PMC6286468 DOI: 10.1016/j.jot.2018.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/22/2018] [Accepted: 07/27/2018] [Indexed: 01/08/2023] Open
Abstract
Background There is a close relationship between the vertebral trabecular morphology and the condition of the associated disc. Objective The relationship between disc degeneration and vertebral trabecular inhomogeneity is unclear. This study aimed to analyse the regional changes of vertebral trabecular morphology after disc degeneration. Methods Thirty male Sprague–Dawley rats were randomly assigned to five groups. Group 1 served as an experimental group for the assessment of disc degeneration induced by needle puncture. Group 2 served as a sham group for trabecular morphology analysis. In Group 3, rats had their tail bent between the eighth and tenth coccygeal vertebrae. In Group 4, the tail of rats was bent with a compression load of 4.5 N. In Group 5, rats first underwent disc degeneration induced by a needle puncture before their tail was bent with a compressive load of 4.5 N. Magnetic resonance imaging was performed on all groups, and histological examination was performed on rodents from Group 1. The ninth coccygeal vertebrae of rats from Groups 2–5 were scanned by Micro-computed tomography. Trabecular morphologic changes were assessed in the concave and convex regions by bone volume fraction, trabecular number, trabecular thickness and trabecular separation. Results Vertebral trabecular morphology in the concave region improved significantly, whereas the convex region was of significantly lower trabecular morphologic parameters with disc degeneration. The difference in trabecular morphologic parameters between the convex and concave regions increased significantly after disc degeneration. Conclusion Disc degeneration promotes regional inhomogeneity in the vertebral trabecular morphology, with the convex region of the vertebrae having the worse trabecular bone morphology than the concave region. The translational potential of this article Our study indicates that disc degeneration promotes regional inhomogeneity in the vertebral trabecular morphology. Regional variations in trabecular microarchitecture are helpful to predict vertebral fragility. This may help to elucidate the mechanisms by which disc degeneration contributes to vertebral fracture.
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Kaiser J, Allaire B, Fein PM, Lu D, Jarraya M, Guermazi A, Demissie S, Samelson EJ, Bouxsein ML, Morgan EF. Correspondence between bone mineral density and intervertebral disc degeneration across age and sex. Arch Osteoporos 2018; 13:123. [PMID: 30421154 PMCID: PMC6291246 DOI: 10.1007/s11657-018-0538-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 10/24/2018] [Indexed: 02/03/2023]
Abstract
The distribution of bone tissue within the vertebra can modulate vertebral strength independently of average density and may change with age and disc degeneration. Our results show that the age-associated decrease in bone density is spatially non-uniform and associated with disc health, suggesting a mechanistic interplay between disc and vertebra. PURPOSE While the decline of bone mineral density (BMD) in the aging spine is well established, the extent to which age influences BMD distribution within the vertebra is less clear. Measures of regional BMD (rBMD) may improve predictions of vertebral strength and suggest how vertebrae might adapt with intervertebral disc degeneration. Thus, we aimed to assess how rBMD values were associated with age, sex, and disc height loss (DHL). METHODS We measured rBMD in the L3 vertebra of 377 participants from the Framingham Heart Study (41-83 years, 181 M/196 F). Integral (Int.BMD) and trabecular BMD (Tb.BMD) were measured from QCT images. rBMD ratios (anterior/posterior, superior/mid-transverse, inferior/mid-transverse, and central/outer) were calculated from the centrum. A radiologist assigned a DHL severity score to adjacent intervertebral discs (L2-L3 and L3-L4). RESULTS Int.BMD and Tb.BMD were both associated with age, though the decrease across age was greater in women (Int.BMD, - 2.6 mg/cm3 per year; Tb.BMD, - 2.6 mg/cm3 per year) than men (Int.BMD, - 0.5 mg/cm3 per year; Tb.BMD, - 1.2 mg/cm3 per year). The central/outer (- 0.027/decade) and superior/mid-transverse (- 0.018/decade) rBMD ratios were negatively associated with age, with similar trends in men and women. Higher Int.BMD or Tb.BMD was associated with increased odds of DHL after adjusting for age and sex. Low central/outer ratio and high anterior/poster and superior/mid-transverse ratios were also associated with increased odds of DHL. CONCLUSIONS Our results indicate that the distribution of bone within the L3 vertebra is different across age, but not between sexes, and is associated with disc degeneration.
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Affiliation(s)
- Jarred Kaiser
- Department of Mechanical Engineering, Boston University, 110 Cummington Street, Boston, MA, 02215, USA.
| | - Brett Allaire
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Paul M Fein
- Department of Mechanical Engineering, Boston University, 110 Cummington Street, Boston, MA, 02215, USA
| | - Darlene Lu
- Department of Biostatistics, Boston University, Boston, MA, USA
| | - Mohamed Jarraya
- Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, Mercy Catholic Medical Center, Darby, PA, USA
| | - Ali Guermazi
- Boston University School of Medicine, Boston, MA, USA
| | | | - Elizabeth J Samelson
- Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Mary L Bouxsein
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Dept of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA
| | - Elise F Morgan
- Department of Mechanical Engineering, Boston University, 110 Cummington Street, Boston, MA, 02215, USA
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Cui J, Liu H, Shao J, Xu DM, Wang Y, Fei Z, Wei J, Lu W, Wang CR, He R, Tan Y, Fan Y, Ning Y, Cassidy RM, Soares JC, Huang X, Zhang XY. Prevalence, risk factors and clinical characteristics of osteoporosis in Chinese inpatients with schizophrenia. Schizophr Res 2018; 195:488-494. [PMID: 29056492 DOI: 10.1016/j.schres.2017.10.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/12/2017] [Accepted: 10/15/2017] [Indexed: 11/26/2022]
Abstract
Patients with schizophrenia have a high prevalence of developing osteoporosis and osteoporosis-related fractures. We examined the prevalence of osteoporosis and its clinical correlates in Chinese patients with schizophrenia, which is not well-studied. A total of 199 inpatients (males/females=132/67; average age: 54.5±11.1years) and 107 healthy controls (males/females=22/85; average age: 41.7±11.9years) were recruited. Bone mineral density (BMD) was measured by ultrasonography of the calcaneus. The prevalence of osteoporosis and low BMD (osteoporosis and osteopenia) was 23.1% and 65.3% for the patient group, versus 7.5% and 39.3% for the control group (both p<0.001). Further, the average BMD T-score in patients was significantly lower than in controls (p<0.05). There was gender difference in the prevalence of low BMD conditions for the patients (males: 56.1% versus females: 76.1%; p<0.01) as well as the BMD T-score (p<0.001). Several risk factors correlated with the osteoporosis classification in the patient group: older age (58.9±11.2years vs. 53.3±11.0years), lower weight (63.7±12.2kg vs. 70.4±15.2kg) and body mass index (BMI) (22.8±4.1kg/m2 vs. 24.2±4.7kg/m2; all p<0.01) than those without osteoporosis. Stepwise multiple logistic regression analysis indicated that age, weight and BMI remained significantly associated with osteoporosis. In addition, correlation analysis showed significant correlations between BMD T-score and the following parameters: gender, age and drug type (clozapine versus non-clozapine) (Bonferroni corrected p's<0.05). Our results suggest a higher prevalence of osteoporosis and osteopenia in Chinese schizophrenic inpatients, with both the expected risk factors of gender and age, as well as drug type.
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Affiliation(s)
- Jingyi Cui
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Huaqing Liu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Jing Shao
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Dong-Mei Xu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yi Wang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Zheng Fei
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Jiyu Wei
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Wei Lu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Chun-Rong Wang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Rui He
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yangya Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yi Fan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, China
| | - Ryan M Cassidy
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Xingbing Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, China.
| | - Xiang Yang Zhang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China; Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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Xie F, Zhou B, Wang J, Liu T, Wu X, Fang R, Kang Y, Dai R. Microstructural properties of trabecular bone autografts: comparison of men and women with and without osteoporosis. Arch Osteoporos 2018; 13:18. [PMID: 29508160 DOI: 10.1007/s11657-018-0422-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 01/21/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED The microstructure of autologous bone grafts from men over 50 years old and postmenopausal women undergoing spinal fusion were evaluated using micro-CT. We demonstrated postmenopausal women, especially those with osteoporosis (OP) presented more serious microarchitectural deterioration of bone grafts. PURPOSE This study was undertaken to determine microstructural properties of cancellous bone used as autologous bone grafts from osteoporosis patients undergoing lumbar fusion by comparing microstructural indices to controls. METHODS Cancellous bone specimens from spinous processes were obtained from 41 postmenopausal women (osteoporosis women, n = 19; controls, n = 22) and 26 men over 50 years old (osteoporosis men, n = 8; controls, n = 18) during lumbar fusion surgery. The microstructural parameters were measured using micro-CT. RESULTS Significant difference in bone volume fraction (BV/TV), specific bone surface (BS/BV), trabecular thickness (Tb.Th), and structure model index (SMI) value existed between postmenopausal women with OP and controls. Significant difference in trabecular number (Tb.N) existed between men over 50 years old with OP and controls. Postmenopausal women exhibited lower BV/TV, Tb.Th, and higher SMI value than men over 50 years old. Postmenopausal women with OP exhibited lower BV/TV, Tb.Th, and higher BS/BV than men over 50 years old with OP. CONCLUSIONS Post-menopausal women and older men with OP have worse bone quality in autografts than non-osteoporotic men and women. Postmenopausal women with OP presented serious microarchitectural deterioration in older population.
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Affiliation(s)
- Fen Xie
- Department of Endocrinology and Metabolism, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, National Clinical Research Center for Metabolic Disease, The Second XiangYa Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China
| | - Bin Zhou
- Department of Spine Surgery, The Second XiangYa Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China
| | - Jian Wang
- Department of Endocrinology and Metabolism, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, National Clinical Research Center for Metabolic Disease, The Second XiangYa Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China
| | - Tang Liu
- Department of Orthopaedics, The Second XiangYa Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China
| | - Xiyu Wu
- Department of Endocrinology and Metabolism, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, National Clinical Research Center for Metabolic Disease, The Second XiangYa Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China
| | - Rui Fang
- Department of Orthopaedics, The Second XiangYa Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China
| | - Yijun Kang
- Department of Spine Surgery, The Second XiangYa Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China.
| | - Ruchun Dai
- Department of Endocrinology and Metabolism, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, National Clinical Research Center for Metabolic Disease, The Second XiangYa Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China.
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Rezaei A, Giambini H, Rossman T, Carlson KD, Yaszemski MJ, Lu L, Dragomir-Daescu D. Are DXA/aBMD and QCT/FEA Stiffness and Strength Estimates Sensitive to Sex and Age? Ann Biomed Eng 2017; 45:2847-2856. [PMID: 28940110 DOI: 10.1007/s10439-017-1914-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 08/31/2017] [Indexed: 10/18/2022]
Abstract
Dual X-ray absorptiometry (DXA) measures areal bone mineral density (aBMD) by simplifying a complex 3D bone structure to a 2D projection and is not equally effective for explaining fracture strength in women and men. Unlike DXA, subject-specific quantitative computed tomography-based finite element analysis (QCT/FEA) estimates fracture strength using 3D bone mineral distribution and geometry. By using experimentally-measured femoral stiffness and strength from a one hundred sample cadaveric cohort that included variations in sex and age, we wanted to determine if QCT/FEA estimates were able to better predict the experimental variations than DXA/aBMD. For each femur, DXA/aBMD was assessed and a QCT/FEA model was developed to estimate femoral stiffness and strength. Then, the femur was mechanically tested to fracture in a sideways fall on the hip position to measure stiffness and strength. DXA/aBMD and QCT/FEA estimates were compared for their sensitivity to sex and age with multivariate statistical analyses. When comparing the measured data with DXA/aBMD predictions, both age and sex were significant (p ≤ 0.0398) for both femoral stiffness and strength. However, QCT/FEA predictions of stiffness and strength showed sex was insignificant (p ≥ 0.23). Age was still significant (p ≤ 0.0072). These results indicate that QCT/FEA, unlike DXA/aBMD, accounted for bone differences due to sex.
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Affiliation(s)
- Asghar Rezaei
- Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 First Street, S.W., Rochester, MN, 55905, USA
| | - Hugo Giambini
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Kent D Carlson
- Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 First Street, S.W., Rochester, MN, 55905, USA
| | | | - Lichun Lu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 First Street, S.W., Rochester, MN, 55905, USA
| | - Dan Dragomir-Daescu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 First Street, S.W., Rochester, MN, 55905, USA.
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Wen XX, Yu HL, Yan YB, Zong CL, Ding HJ, Ma XY, Wang TS, Lei W. Influence of the shape of the micro-finite element model on the mechanical properties calculated from micro-finite element analysis. Exp Ther Med 2017; 14:1744-1748. [PMID: 28810645 DOI: 10.3892/etm.2017.4709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 04/21/2017] [Indexed: 11/05/2022] Open
Abstract
Assessing the biomechanical properties of trabecular bone is of major biological and clinical significance for the research of bone diseases, fractures and their treatments. Micro-finite element (µFE) models are becoming increasingly popular for investigating the biomechanical properties of trabecular bone. The shapes of µFE models typically include cube and cylinder. Whether there are differences between cubic and cylindrical µFE models has not yet been studied. In the present study, cubic and cylindrical µFE models of human vertebral trabecular bone were constructed. A 1% strain was prescribed to the model along the superior-inferior direction. E values were calculated from these models, and paired t-tests were performed to determine whether these were any differences between E values obtained from cubic and cylindrical models. The results demonstrated that there were no statistically significant differences in the E values between cubic and cylindrical models, and there were no significant differences in Von Mises stress distributions between the two models. These findings indicated that, to construct µFE models of vertebral trabecular bone, cubic or cylindrical models were both feasible. Choosing between the cubic or cylindrical µFE model is dependent upon the specific study design.
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Affiliation(s)
- Xin-Xin Wen
- Department of Orthopedics, 463 Hospital of PLA, Shenyang, Liaoning 110042, P.R. China
| | - Hai-Long Yu
- Department of Orthopedics, General Hospital of Shenyang Military Area Command of PLA, Rescue Center of Severe Wound and Trauma of PLA, Shenyang, Liaoning 110016, P.R. China
| | - Ya-Bo Yan
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Chun-Lin Zong
- Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Hai-Jiao Ding
- Department of Orthopedics, 463 Hospital of PLA, Shenyang, Liaoning 110042, P.R. China
| | - Xiang-Yu Ma
- Department of Orthopedics, 463 Hospital of PLA, Shenyang, Liaoning 110042, P.R. China
| | - Tian-Sheng Wang
- Department of Orthopedics, 463 Hospital of PLA, Shenyang, Liaoning 110042, P.R. China
| | - Wei Lei
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
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Fürst D, Senck S, Hollensteiner M, Esterer B, Augat P, Eckstein F, Schrempf A. Characterization of synthetic foam structures used to manufacture artificial vertebral trabecular bone. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 76:1103-1111. [PMID: 28482474 DOI: 10.1016/j.msec.2017.03.158] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 03/17/2017] [Accepted: 03/18/2017] [Indexed: 11/30/2022]
Abstract
Artificial materials reflecting the mechanical properties of human bone are essential for valid and reliable implant testing and design. They also are of great benefit for realistic simulation of surgical procedures. The objective of this study was therefore to characterize two groups of self-developed synthetic foam structures by static compressive testing and by microcomputed tomography. Two mineral fillers and varying amounts of a blowing agent were used to create different expansion behavior of the synthetic open-cell foams. The resulting compressive and morphometric properties thus differed within and also slightly between both groups. Apart from the structural anisotropy, the compressive and morphometric properties of the synthetic foam materials were shown to mirror the respective characteristics of human vertebral trabecular bone in good approximation. In conclusion, the artificial materials created can be used to manufacture valid synthetic bones for surgical training. Further, they provide novel possibilities for studying the relationship between trabecular bone microstructure and biomechanical properties.
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Affiliation(s)
- David Fürst
- Research Group for Surgical Simulators Linz, Upper Austria University of Applied Sciences, Linz, Austria.
| | - Sascha Senck
- Computed Tomography Research Group, Upper Austria University of Applied Sciences, Wels, Austria
| | - Marianne Hollensteiner
- Research Group for Surgical Simulators Linz, Upper Austria University of Applied Sciences, Linz, Austria
| | - Benjamin Esterer
- Research Group for Surgical Simulators Linz, Upper Austria University of Applied Sciences, Linz, Austria
| | - Peter Augat
- Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau and Paracelsus Medical University, Murnau, Germany; Institute of Anatomy, Paracelsus Medical University of Salzburg & Nuremberg, Salzburg, Austria
| | - Felix Eckstein
- Institute of Anatomy, Paracelsus Private Medical University of Salzburg, Salzburg, Austria; Institute of Anatomy, Paracelsus Medical University - Campus Nuremberg, Nuremberg, Austria
| | - Andreas Schrempf
- Research Group for Surgical Simulators Linz, Upper Austria University of Applied Sciences, Linz, Austria. http://ressl.fh-linz.at
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Azuma K, Ogura M, Kondo H, Suzuki A, Hayashi S, Iinuma M, Onozuka M, Kubo KY. Maternal Active Mastication during Prenatal Stress Ameliorates Prenatal Stress-Induced Lower Bone Mass in Adult Mouse Offspring. Int J Med Sci 2017; 14:348-355. [PMID: 28553167 PMCID: PMC5436477 DOI: 10.7150/ijms.18298] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 01/31/2017] [Indexed: 11/13/2022] Open
Abstract
Chronic psychological stress is a risk factor for osteoporosis. Maternal active mastication during prenatal stress attenuates stress response. The aim of this study is to test the hypothesis that maternal active mastication influences the effect of prenatal stress on bone mass and bone microstructure in adult offspring. Pregnant ddY mice were randomly divided into control, stress, and stress/chewing groups. Mice in the stress and stress/chewing groups were placed in a ventilated restraint tube for 45 minutes, 3 times a day, and was initiated on day 12 of gestation and continued until delivery. Mice in the stress/chewing group were allowed to chew a wooden stick during the restraint stress period. The bone response of 5-month-old male offspring was evaluated using quantitative micro-CT, bone histomorphometry, and biochemical markers. Prenatal stress resulted in significant decrease of trabecular bone mass in both vertebra and distal femur of the offspring. Maternal active mastication during prenatal stress attenuated the reduced bone formation and increased bone resorption, improved the lower trabecular bone volume and bone microstructural deterioration induced by prenatal stress in the offspring. These findings indicate that maternal active mastication during prenatal stress can ameliorate prenatal stress-induced lower bone mass of the vertebra and femur in adult offspring. Active mastication during prenatal stress in dams could be an effective coping strategy to prevent lower bone mass in their offspring.
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Affiliation(s)
- Kagaku Azuma
- Department of Anatomy, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Minori Ogura
- Department of Pediatric Dentistry, Asahi University School of Dentistry, 1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Hiroko Kondo
- Department of Pediatric Dentistry, Asahi University School of Dentistry, 1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Ayumi Suzuki
- Department of Pediatric Dentistry, Asahi University School of Dentistry, 1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Sakurako Hayashi
- Department of Pediatric Dentistry, Asahi University School of Dentistry, 1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Mitsuo Iinuma
- Department of Pediatric Dentistry, Asahi University School of Dentistry, 1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Minoru Onozuka
- Department of Judo Therapy and Medical Science, Faculty of Medical Science, Nippon Sport Science University, Yokohama Kanagawa, 227-0033, Japan
| | - Kin-Ya Kubo
- Seijoh University Graduate School of Health Care Studies, 2-172, Fukinodai, Tokai, Aichi, 476-8588, Japan
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Sritara C, Thakkinstian A, Ongphiphadhanakul B, Amnuaywattakorn S, Utamakul C, Akrawichien T, Vathesatogkit P, Sritara P. Age-Adjusted Dual X-ray Absorptiometry-Derived Trabecular Bone Score Curve for the Lumbar Spine in Thai Females and Males. J Clin Densitom 2016; 19:494-501. [PMID: 26095196 DOI: 10.1016/j.jocd.2015.05.068] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 05/19/2015] [Accepted: 05/21/2015] [Indexed: 02/01/2023]
Abstract
Trabecular bone score (TBS), which has been shown to discriminate patients with fractures from healthy individuals, decreases with age. This study was conducted to derive an age-adjusted normative TBS curve for each gender aged 30-80 + years to serve as reference data for Thai males and females. A cross-sectional study was conducted among employees from the Electricity Generating Authority of Thailand cohorts, after excluding those with conditions potentially affecting bone metabolism and analysis. The values of TBS at L1-L4 vertebrae were analyzed using a commercial software. Age-adjusted TBS curves were constructed using segmental linear regression analysis for each gender. Additional analysis was also performed on TBS with age, body mass index, and body mineral density (BMD) at L1-L4 vertebrae as covariates. A database of 848 healthy subjects (341 females and 507 males) aged 30-80+ years was created. The BMDs of both male and female subjects in the youngest decade were not statistically different from previous reports (p = 0.31 and 0.22 for females and males, respectively). In this age group, the mean TBS was higher in females, albeit not statistically significant (p = 0.12). Between the ages of 30-80+ years, female and male TBS dropped by 19.8% (0.40% per year) and 10.1% (0.20% per year), respectively. The association with TBS was weak for body mass index and moderate for BMD (coefficients of about -0.01 and 0.4-0.5, respectively). The age-adjusted reference curves for healthy Thai females and males aged 30-80+ years have been established.
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Affiliation(s)
- Chanika Sritara
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Ammarin Thakkinstian
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Boonsong Ongphiphadhanakul
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sasithorn Amnuaywattakorn
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chirawat Utamakul
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tawatchai Akrawichien
- Medical and Health Office, Electricity Generating Authority of Thailand, Nonthaburi, Thailand
| | - Prin Vathesatogkit
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Piyamitr Sritara
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Modeling the Mechanical Consequences of Age-Related Trabecular Bone Loss by XFEM Simulation. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2016; 2016:3495152. [PMID: 27403206 PMCID: PMC4925952 DOI: 10.1155/2016/3495152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 05/23/2016] [Indexed: 11/18/2022]
Abstract
The elderly are more likely to suffer from fracture because of age-related trabecular bone loss. Different bone loss locations and patterns have different effects on bone mechanical properties. Extended finite element method (XFEM) can simulate fracture process and was suited to investigate the effects of bone loss on trabecular bone. Age-related bone loss is indicated by trabecular thinning and loss and may occur at low-strain locations or other random sites. Accordingly, several ideal normal and aged trabecular bone models were created based on different bone loss locations and patterns; then, fracture processes from crack initiation to complete failure of these models were observed by XFEM; finally, the effects of different locations and patterns on trabecular bone were compared. Results indicated that bone loss occurring at low-strain locations was more detrimental to trabecular bone than that occurring at other random sites; meanwhile, the decrease in bone strength caused by trabecular loss was higher than that caused by trabecular thinning, and the effects of vertical trabecular loss on mechanical properties were more severe than horizontal trabecular loss. This study provided a numerical method to simulate trabecular bone fracture and distinguished different effects of the possible occurrence of bone loss locations and patterns on trabecular bone.
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Wang B, Overgaard S, Chemnitz J, Ding M. Cancellous and Cortical Bone Microarchitectures of Femoral Neck in Rheumatoid Arthritis and Osteoarthritis Compared with Donor Controls. Calcif Tissue Int 2016; 98:456-64. [PMID: 26677127 DOI: 10.1007/s00223-015-0098-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022]
Abstract
This study investigated the 3D microarchitecture of cancellous and cortical bones of the femoral neck in rheumatoid arthritis (RA), osteoarthritis (OA) and donor controls. 26 femoral necks (including heads) were harvested during total hip replacement surgeries in 11 patients with RA (mean age 66.7 ± 12.8 years) and 15 patients with OA (67.3 ± 8.4 years). Femoral heads/necks were also harvested from 8 donors (74.9 ± 10.2 years). Bone samples of 10 mm thickness were prepared from each femoral neck and scanned with micro-CT to evaluate microarchitectural parameters. The RA and OA samples showed no significant differences in microarchitectural parameters in cancellous or cortical bone. Compared with the donor controls, bone volume fraction in RA and OA cancellous bone was significantly greater, the structure model index in OA was significantly lower, and the surface density in RA was significantly greater. The RA bone tissues showed erosion and marked osteophyte formation. This study demonstrated that RA and OA have similar trends of overall microarchitectural degeneration in the femoral neck, despite marked erosion in RA bone and osteophyte formation in OA bone. However, we could not eliminate the possibility of local differences between RA and OA bone. The age-related bone loss in RA and OA was less severe than those of normal ageing and osteoporosis, suggesting a compensatory effect of the diseases to increase bone density.
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Affiliation(s)
- Bailiang Wang
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery & Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J.B. Winsloewsvej 15, 3rd floor, 5000, Odense C, Denmark
- Department of Joint Surgery, China-Japan Friendship Hospital, 2 Ying-Hua-Dong Street, Chaoyang District, Beijing, 100029, China
| | - Søren Overgaard
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery & Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J.B. Winsloewsvej 15, 3rd floor, 5000, Odense C, Denmark
| | - John Chemnitz
- Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5230, Odense M, Denmark
| | - Ming Ding
- Orthopaedic Research Laboratory, Department of Orthopaedic Surgery & Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, J.B. Winsloewsvej 15, 3rd floor, 5000, Odense C, Denmark.
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Lopez-Diaz V, Smith Pellizzeri TM, Lijewski MD, Ruhlandt K, Zubieta J. Metal-organodiphosphonate chemistry: Hydrothermal syntheses and structures of Ca(II) coordination polymers with xylyldiphosphonate ligands. Inorganica Chim Acta 2016. [DOI: 10.1016/j.ica.2015.11.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Munemoto M, Kido A, Sakamoto Y, Inoue K, Yokoi K, Shinohara Y, Tanaka Y. Analysis of trabecular bone microstructure in osteoporotic femoral heads in human patients: in vivo study using multidetector row computed tomography. BMC Musculoskelet Disord 2016; 17:13. [PMID: 26758746 PMCID: PMC4710991 DOI: 10.1186/s12891-015-0848-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 12/07/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lag screw position is very important in the treatment of intertrochanteric femoral fracture to prevent complications such as screw cut-out. Current studies recommend central or inferior placement of the lag screw on the anteroposterior radiograph, and central placement on the lateral radiographs. These reports are based on radiographic evaluation, but few studies have investigated the importance of bone quality at the site of lag screw placement. In this study, we used multidetector row computed tomography (MDCT) to perform in vivo evaluation of the bone microstructure of the femoral head in patients with intertrochanteric femoral fractures. METHODS This study was approved by the Ethics Committee of Okanami General Hospital. MDCT images were obtained in our hospital from ten patients who had sustained intertrochanteric femoral fracture. Patients who needed computed tomography to confirm fracture morphology were included. We defined six areas as regions of interest (ROI): ROI 1-3 were defined as the femoral head apex area, and ROI 4-6 were defined as the femoral neck area. Trabecular microstructure parameters, including mean bone volume to total volume (BV/TV), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), and structure model index (SMI), were evaluated with bone analysis software (TRI/3D-BON). Statistical analyses were performed using EZR software; each parameter among the ROIs was statistically evaluated by analysis of variance (ANOVA) and Tukey's test. Statistical significance was established at p < 0.05. RESULTS In the apical area, all parameters indicated that ROI 1 (superior) had the highest bone quality and ROI 2 (central) was higher in bone quality than ROI 3 (inferior). In the femoral neck, all parameters indicated that bone quality was significantly greater in ROI 6 (inferior) than ROI 5 (central). DISCUSSION AND CONCLUSIONS We could evaluate bone quality with clinical MDCT in vivo. Bone quality in the central area of the femoral head apical was greater than in the inferior area, and bone quality in the inferior area of the femoral neck was greater than in the central area. Recognizing which area of femoral head has greater bone quality may lead to a better clinical result in treating intertrochanteric femoral fracture.
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Affiliation(s)
- Mitsuru Munemoto
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan. .,Department of Orthopaedic Surgery, Okanami General Hospital, 1784 Uenokuuwamachi, Iga, Mie, 518-0842, Japan.
| | - Akira Kido
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan.
| | - Yoshihiro Sakamoto
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan.
| | - Kazuya Inoue
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan.
| | - Kazuyuki Yokoi
- Department of Orthopaedic Surgery, Okanami General Hospital, 1784 Uenokuuwamachi, Iga, Mie, 518-0842, Japan.
| | - Yasushi Shinohara
- Department of Orthopaedic Surgery, Okanami General Hospital, 1784 Uenokuuwamachi, Iga, Mie, 518-0842, Japan.
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan.
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Tseng PT, Chen YW, Yeh PY, Tu KY, Cheng YS, Wu CK. Bone Mineral Density in Schizophrenia: An Update of Current Meta-Analysis and Literature Review Under Guideline of PRISMA. Medicine (Baltimore) 2015; 94:e1967. [PMID: 26632691 PMCID: PMC5058960 DOI: 10.1097/md.0000000000001967] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Numerous reports have discussed bone mineral density (BMD) or the risk of osteoporosis in schizophrenia, but have yielded only controversial results.We conducted an update of meta-analysis to examine the overall change in BMD in patients with schizophrenia and the effect on BMD of different antipsychotic drugs.Electronic research through platform of PubMed.The inclusion criteria were as follows: articles with relevance to comparisons of BMD in patients with schizophrenia (SCHIZ) and healthy controls (HCs), or articles discussing comparisons of BMD in SCHIZ receiving prolactin-raising (PR) and prolactin-sparing (PS) antipsychotics; articles about clinical trials.In the current meta-analysis, we used the random-effect model to pool the results from 13 studies comparing BMD in SCHIZ and in HCs, and the results from 7 studies comparing BMD in patients receiving PR and PS.Our results revealed significantly lower BMD in SCHIZ than in HCs (P < 0.001). In the meta-regression, mean age of subjects modulated the difference in BMD between patients and control subjects (P < 0.001). In addition, the BMD in SCHIZ taking PR was significantly lower than in those taking PS (P = 0.006).Our study can only point to the phenomenon that BMD in SCHIZ is lower than that in HCs, and cannot reveal any possible pathophysiology or mechanism of this phenomenon. In addition, we could not rule out the possible effect of medication on BMD based on the results of the meta-analysis of comparison of BMD in SCHIZ receiving PR and PS.The main result of our meta-analysis suggests that BMD is significantly lower in SCHIZ than in HCs. Our study emphasizes the importance of further screening for the risk of osteoporosis in young-aged schizophrenic patients, especially those taking PR, which are in high risk of fracture.
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Affiliation(s)
- Ping-Tao Tseng
- From the Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home (PT, T, K-YT, Y-SC, C-KW), Department of Neurology, E-Da Hospital, Kaohsiung (YW, C), Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan (P-YY); and Department of Clinical Psychology, Tsyr-Huey Mental Hospital, Kaohsiung, Taiwan (P-YY)
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Liu J, Wang Y, Song S, Wang X, Qin Y, Si S, Guo Y. Combined oral administration of bovine collagen peptides with calcium citrate inhibits bone loss in ovariectomized rats. PLoS One 2015; 10:e0135019. [PMID: 26258559 PMCID: PMC4530891 DOI: 10.1371/journal.pone.0135019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 07/16/2015] [Indexed: 01/28/2023] Open
Abstract
Purpose Collagen peptides (CPs) and calcium citrate are commonly used as bone health supplements for treating osteoporosis. However, it remains unknown whether the combination of oral bovine CPs with calcium citrate is more effective than administration of either agent alone. Methods Forty 12-week-old Sprague-Dawley rats were randomly divided into five groups (n = 8) for once-daily intragastric administration of different treatments for 3 months at 3 months after ovariectomy (OVX) as follows: sham + vehicle; OVX + vehicle; OVX + 750 mg/kg CP; OVX + CP-calcium citrate (75 mg/kg); OVX + calcium citrate (75 mg/kg). After euthanasia, the femurs were removed and analyzed by dual energy X-ray absorptiometry and micro-computed tomography, and serum samples were analyzed for bone metabolic markers. Results OVX rats supplemented with CPs or CP-calcium citrate showed osteoprotective effects, with reductions in the OVX-induced decreases in their femoral bone mineral density. Moreover, CP-calcium citrate prevented trabecular bone loss, improved the microarchitecture of the distal femur, and significantly inhibited bone loss with increased bone volume, connectivity density, and trabecular number compared with OVX control rats. CP or CP-calcium citrate administration significantly increased serum procollagen type I N-terminal propeptide levels and reduced serum bone-specific alkaline phosphatase, osteocalcin, and C-telopeptide of type I collagen levels. Conclusions Our data indicate that combined oral administration of bovine CPs with calcium citrate inhibits bone loss in OVX rats. The present findings suggest that combined oral administration of bovine CPs with calcium citrate is a promising alternative for reducing bone loss in osteopenic postmenopausal women.
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Affiliation(s)
- JunLi Liu
- Key Laboratory of Photochemical Conversion and Optoelectronic Materials, Technical Institute of Physics and Chemistry, Chinese Academy of Science, Beijing, People’s Republic of China
- Center for Special Medicine and Experimental Research, 306 Hospital of PLA, Beijing, People’s Republic of China
| | - YiHu Wang
- Key Laboratory of Photochemical Conversion and Optoelectronic Materials, Technical Institute of Physics and Chemistry, Chinese Academy of Science, Beijing, People’s Republic of China
| | - ShuJun Song
- Center for Special Medicine and Experimental Research, 306 Hospital of PLA, Beijing, People’s Republic of China
| | - XiJie Wang
- Key Laboratory of Photochemical Conversion and Optoelectronic Materials, Technical Institute of Physics and Chemistry, Chinese Academy of Science, Beijing, People’s Republic of China
| | - YaYa Qin
- Center for Special Medicine and Experimental Research, 306 Hospital of PLA, Beijing, People’s Republic of China
| | - ShaoYan Si
- Center for Special Medicine and Experimental Research, 306 Hospital of PLA, Beijing, People’s Republic of China
- * E-mail: (YCG); (SYS)
| | - YanChuan Guo
- Key Laboratory of Photochemical Conversion and Optoelectronic Materials, Technical Institute of Physics and Chemistry, Chinese Academy of Science, Beijing, People’s Republic of China
- * E-mail: (YCG); (SYS)
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Bou-Francis A, Widmer Soyka RP, Ferguson SJ, Hall RM, Kapur N. Novel methodology for assessing biomaterial–biofluid interaction in cancellous bone. J Mech Behav Biomed Mater 2015; 46:158-67. [DOI: 10.1016/j.jmbbm.2015.02.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 02/24/2015] [Indexed: 12/26/2022]
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Thomsen JS, Jensen MV, Niklassen AS, Ebbesen EN, Brüel A. Age-related changes in vertebral and iliac crest 3D bone microstructure--differences and similarities. Osteoporos Int 2015; 26:219-28. [PMID: 25164697 DOI: 10.1007/s00198-014-2851-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 08/11/2014] [Indexed: 10/24/2022]
Abstract
UNLABELLED Age-related changes of vertebra and iliac crest 3D microstructure were investigated, and we showed that they were in general similar. The 95th percentile of vertebral trabecular thickness distribution increased with age for women. Surprisingly, vertebral and iliac crest bone microstructure was only weakly correlated (r = 0.38 to 0.75), despite the overall similar age-related changes. INTRODUCTION The purposes of the study were to determine the age-related changes in iliac and vertebral bone microstructure for women and men over a large age range and to investigate the relationship between the bone microstructure at these skeletal sites. METHODS Matched sets of transiliac crest bone biopsies and lumbar vertebral body (L2) specimens from 41 women (19-96 years) and 39 men (23-95 years) were micro-computed tomography (μCT) scanned, and the 3D microstructure was quantified. RESULTS For both women and men, bone volume per total volume (BV/TV), connectivity density (CD), and trabecular number (Tb.N) decreased significantly, while structure model index (SMI) and trabecular separation (Tb.Sp) increased significantly with age at either skeletal site. Vertebral trabecular thickness (Tb.Th) was independent of age for both women and men, while iliac Tb.Th decreased significantly with age for men, but not for women. In general, the vertebral and iliac age-related changes were similar. The 95th percentile of the Tb.Th distribution increased significantly with age for women but was independent of age for men at the vertebral body, while it was independent of age for either sex at the iliac crest. The Tb.Th probability density functions at the two skeletal sites became significantly more similar with age for women, but not for men. The microstructural parameters at the iliac crest and the vertebral bodies were only moderately correlated from r = 0.38 for SMI in women to r = 0.75 for Tb.Sp in men. CONCLUSION Age-related changes in vertebral and iliac bone microstructure were in general similar. The iliac and vertebral Tb.Th distributions became more similar with age for women. Despite the overall similar age-related changes in trabecular bone microstructure, the vertebral and iliac bone microstructural measures were only weakly correlated (r = 0.38 to 0.75).
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Affiliation(s)
- J S Thomsen
- Department of Biomedicine-Anatomy, Aarhus University, Wilhelm Meyers Allé 3, 8000, Aarhus C, Denmark,
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Acquaah F, Robson Brown KA, Ahmed F, Jeffery N, Abel RL. Early Trabecular Development in Human Vertebrae: Overproduction, Constructive Regression, and Refinement. Front Endocrinol (Lausanne) 2015; 6:67. [PMID: 26106365 PMCID: PMC4458883 DOI: 10.3389/fendo.2015.00067] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/14/2015] [Indexed: 01/18/2023] Open
Abstract
Early bone development may have a significant impact upon bone health in adulthood. Bone mineral density (BMD) and bone mass are important determinants of adult bone strength. However, several studies have shown that BMD and bone mass decrease after birth. If early development is important for strength, why does this reduction occur? To investigate this, more data characterizing gestational, infant, and childhood bone development are needed in order to compare with adults. The aim of this study is to document early vertebral trabecular bone development, a key fragility fracture site, and infer whether this period is important for adult bone mass and structure. A series of 120 vertebrae aged between 6 months gestation and 2.5 years were visualized using microcomputed tomography. Spherical volumes of interest were defined, thresholded, and measured using 3D bone analysis software (BoneJ, Quant3D). The findings showed that gestation was characterized by increasing bone volume fraction whilst infancy was defined by significant bone loss (≈2/3rds) and the appearance of a highly anisotropic trabecular structure with a predominantly inferior-superior direction. Childhood development progressed via selective thickening of some trabeculae and the loss of others; maintaining bone volume whilst creating a more anisotropic structure. Overall, the pattern of vertebral development is one of gestational overproduction followed by infant "sculpting" of bone tissue during the first year of life (perhaps in order to regulate mineral homeostasis or to adapt to loading environment) and then subsequent refinement during early childhood. Comparison of early bone developmental data in this study with adult bone volume values taken from the literature shows that the loss in bone mass that occurs during the first year of life is never fully recovered. Early development could therefore be important for developing bone strength, but through structural changes in trabecular microarchitecture rather than bone mass.
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Affiliation(s)
- Frank Acquaah
- MSk Laboratory, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- School of Medicine, King’s College London, London, UK
| | - Katharine A. Robson Brown
- Department of Archaeology and Anthropology, University of Bristol, Bristol, UK
- *Correspondence: Katharine A. Robson Brown, Department of Archaeology and Anthropology, University of Bristol, 43 Woodland Road, Bristol BS8 1UU, UK,
| | - Farah Ahmed
- Department of Mineralogy, The Natural History Museum, London, UK
| | - Nathan Jeffery
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Richard L. Abel
- MSk Laboratory, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Department of Mineralogy, The Natural History Museum, London, UK
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Syahrom A, Abdul Kadir MR, Harun MN, Öchsner A. Permeability study of cancellous bone and its idealised structures. Med Eng Phys 2014; 37:77-86. [PMID: 25523865 DOI: 10.1016/j.medengphy.2014.11.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 09/03/2014] [Accepted: 11/05/2014] [Indexed: 11/29/2022]
Abstract
Artificial bone is a suitable alternative to autografts and allografts, however their use is still limited. Though there were numerous reports on their structural properties, permeability studies of artificial bones were comparably scarce. This study focused on the development of idealised, structured models of artificial cancellous bone and compared their permeability values with bone surface area and porosity. Cancellous bones from fresh bovine femur were extracted and cleaned following an established protocol. The samples were scanned using micro-computed tomography (μCT) and three-dimensional models of the cancellous bones were reconstructed for morphology study. Seven idealised and structured cancellous bone models were then developed and fabricated via rapid prototyping technique. A test-rig was developed and permeability tests were performed on the artificial and real cancellous bones. The results showed a linear correlation between the permeability and the porosity as well as the bone surface area. The plate-like idealised structure showed a similar value of permeability to the real cancellous bones.
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Affiliation(s)
- Ardiyansyah Syahrom
- Sport Innovation and Technology Center (SITC), Universiti Teknologi MalaysiaJ, Johor, Malaysia.
| | - Mohammed Rafiq Abdul Kadir
- Medical Device Technology Group, Faculty of Biomedical Engineering and Health Science, Universiti Teknologi Malaysia, Johor, Malaysia
| | - Muhamad Nor Harun
- Sport Innovation and Technology Center (SITC), Universiti Teknologi MalaysiaJ, Johor, Malaysia
| | - Andreas Öchsner
- Griffith School of Engineering, Griffith University, Australia
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Chen H, Kubo KY. Bone three-dimensional microstructural features of the common osteoporotic fracture sites. World J Orthop 2014; 5:486-495. [PMID: 25232524 PMCID: PMC4133454 DOI: 10.5312/wjo.v5.i4.486] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 04/03/2014] [Accepted: 06/03/2014] [Indexed: 02/06/2023] Open
Abstract
Osteoporosis is a common metabolic skeletal disorder characterized by decreased bone mass and deteriorated bone structure, leading to increased susceptibility to fractures. With aging population, osteoporotic fractures are of global health and socioeconomic importance. The three-dimensional microstructural information of the common osteoporosis-related fracture sites, including vertebra, femoral neck and distal radius, is a key for fully understanding osteoporosis pathogenesis and predicting the fracture risk. Low vertebral bone mineral density (BMD) is correlated with increased fracture of the spine. Vertebral BMD decreases from cervical to lumbar spine, with the lowest BMD at the third lumbar vertebra. Trabecular bone mass of the vertebrae is much lower than that of the peripheral bone. Cancellous bone of the vertebral body has a complex heterogeneous three-dimensional microstructure, with lower bone volume in the central and anterior superior regions. Trabecular bone quality is a key element to maintain the vertebral strength. The increased fragility of osteoporotic femoral neck is attributed to low cancellous bone volume and high compact porosity. Compared with age-matched controls, increased cortical porosity is observed at the femoral neck in osteoporotic fracture patients. Distal radius demonstrates spatial inhomogeneous characteristic in cortical microstructure. The medial region of the distal radius displays the highest cortical porosity compared with the lateral, anterior and posterior regions. Bone strength of the distal radius is mainly determined by cortical porosity, which deteriorates with advancing age.
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Perilli E, Parkinson IH, Truong LH, Chong KC, Fazzalari NL, Osti OL. Modic (endplate) changes in the lumbar spine: bone micro-architecture and remodelling. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2014; 24:1926-34. [PMID: 25063369 DOI: 10.1007/s00586-014-3455-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 07/01/2014] [Accepted: 07/02/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE In the literature, inter-vertebral MRI signal intensity changes (Modic changes) were associated with corresponding histological observations on endplate biopsies. However, tissue-level studies were limited. No quantitative histomorphometric study on bone biopsies has yet been conducted for Modic changes. The aim of this study was to characterise the bone micro-architectural parameters and bone remodelling indices associated with Modic changes. METHODS Forty patients suffering from disabling low back pain, undergoing elective spinal surgery, and exhibiting Modic changes on MRI (Modic 1, n = 9; Modic 2, n = 25; Modic 3, n = 6), had a transpedicular vertebral body biopsy taken of subchondral bone. Biopsies were first examined by micro-CT, for 3D morphometric analysis of bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular separation, trabecular number, and structure model index. Then, samples underwent histological analysis, for determination of bone remodelling indices: osteoid surface to bone surface ratio (OS/BS), eroded surface to bone surface (ES/BS) and osteoid surface to eroded surface ratio (OS/ES). RESULTS Micro-CT analysis revealed significantly higher BV/TV (up to 70% increase, p < 0.01) and Tb.Th (up to +57%, p < 0.01) in Modic 3 biopsies, compared to Modic 1 and 2. Histological analysis showed significantly lower OS/BS in Modic 2 biopsies (more than 28% decrease, p < 0.05) compared to 1 and 3. ES/BS progressively decreased from Modic 1 to 2 to 3, whereas OS/ES progressively increased with significantly higher values in Modic 3 (up to 159% increase, p < 0.05) than in Modic 1 and 2. CONCLUSIONS Significant differences were found in bone micro-architectural parameters and remodelling indices among Modic types. Modic 1 biopsies had evidence of highest bone turnover, possibly due to an inflammatory process; Modic 2 biopsies were consistent with a reduced bone formation/remodelling stage; Modic 3 biopsies suggested a more stable sclerotic phase, with significantly increased BV/TV and Tb.Th compared to Modic 1 and 2, linked to increased bone formation and reduced resorption.
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Affiliation(s)
- Egon Perilli
- Medical Device Research Institute, School of Computer Science, Engineering and Mathematics, Flinders University, Sturt Rd., Bedford Park, South Australia, 5042, Australia,
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