Anat Cell Biol.  2021 Mar;54(1):25-34. 10.5115/acb.20.269.

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

• Schröder G
• Jabke B
• Schulze M
• Wree A
• Martin H
• Sahmel O
• Doerell A
• Kullen CM
• Andresen R
• Schober HC

• KMID: 2514579
• DOI: http://doi.org/10.5115/acb.20.269

Abstract

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.

Keyword

Osteoporosis; Aging; X-ray microtomography; Spine

Figure

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  Fig. 1 (A) Skin incision along the spinous process from the sacrum to the occiput (superior nuchal line); secondary spinal muscles (including the trapezius muscle, the latissimus dorsi, major and minor rhomboid, superior and inferior posterior serratus muscles), skin and subcutaneous fatty tissue were shifted laterally. Left: the subsequent lateral tract of the autochthonous spinal muscles was removed and the ribs were exposed. (B) The spinal muscles have been largely removed; the intercostal spaces have been emptied in the paravertebral aspect. The pleura has been separated from the inside of the ribs, the atlanto-occipital joint is exposed and the capsular ligaments have been transected. The cervical spine has been mobilized in the retropharyngeal space, the scalenemuscles have been transected. (C) Transection of all ribs about 1.5 inches wide in the paravertebral aspect of the spinous processes, along the scapular line. Separation of the parietal pleura from the inside of the ribs, wedge-shaped incision in the sacrum. (D) Complete specimen of the spine.

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  Fig. 2 (A) Spine in a water bath, registration of vertebral deformities on the lateral image. (B) Three-dimensional reconstruction to visualize the overall anatomy of the spine. (C) Prepared spinal column with reconstructed cancellous bone cylinders in micro-computed tomography. CS, cervical spine; LS, lumbar spine; TS, thoracic spine.

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  Fig. 3 (A) Regional variation in vertebral trabecular BVF. Cervical vertebrae exhibit significantly higher BVF in relation to thoracic and lumbar vertebrae (Kruskal-Wallis-test, P-values in Table 2). The subgroup analysis using the Mann-Whitney U-test showed no significant difference between women and men or between those over and under 80 years of age (P>0.05). (B) Regional variation in Tb.Th. Cervical vertebrae exhibit significantly higher Tb.Th in relation to thoracic and lumbar vertebrae. Only in the over-80s is there no significant difference between the cervical and lumbar vertebrae (Kruskal-Wallis-test, P-values in Table 2). The subgroup analysis using the Mann-Whitney U-test showed no significant difference between women and men or between those over and under 80 years of age (P>0.05). (C) Regional variation in DA. Cervical vertebrae exhibit significantly lower DA in relation to thoracic and lumbar vertebrae (ANOVA, post-hoc LSD test, P-values in Table 2). The subgroup analysis using the independent t-test showed a significant difference between women and men (P=0.042) and no significant difference between those over and under 80 years of age (P>0.05). (D) Regional variation in Tb.Sp. Cervical vertebrae exhibit significantly lower Tb.Sp in relation to thoracic and lumbar vertebrae (ANOVA, post-hoc LSD test, P-values in Table 2). The subgroup analysis using the independent t-test showed no significant difference between women and men or between those over and under 80 years of age (P>0.05). (E) Regional variation in Tb.N. Cervical vertebrae exhibit significantly higher Tb.N in relation to thoracic and lumbar vertebrae (ANOVA, post-hoc LSD test, P-values in Table 2). The subgroup analysis using the independent t-test showed no significant difference between women and men or between those over and under 80 years of age (P>0.05). BVF, bone volume fraction; DA, degree of anisotropy; Tb.N, trabecular number; Tb.Sp, trabecular separation; Tb.Th, trabecular bone thickness.

Reference

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