K. Oda et al., MORPHOGENESIS OF VERTEBRAL DEFORMITIES IN INVOLUTIONAL OSTEOPOROSIS -AGE-RELATED, 3-DIMENSIONAL TRABECULAR STRUCTURE, Spine (Philadelphia, Pa. 1976), 23(9), 1998, pp. 1050-1055
Study Design. The relation between the semiquantitative data of altera
tion in three-dimensional trabecular structure and deformities of the
vertebral body was analyzed to clarify the morphogenesis of vertebral
deformities in involutional osteoporosis. Objectives. To evaluate semi
quantitatively the age-related alterations of the three-dimensional st
ructure of trabeculae of the vertebral body and to clarify their relat
ion to vertebral deformities in involutional osteoporosis. Summary of
Background Data. Recent studies have shown that bone fractures and def
ormities in osteoporosis do not depend only on a reduced amount of bon
e tissue. There is no previous study on the relation between bone defo
rmity and the alterations of the three-dimensional structure of trabec
ulae. Methods. The second lumbar vertebrae were removed at autopsy fro
m 25 patients who had no disease predisposing them to secondary osteop
orosis and no severe vertebral deformities. The sections of the verteb
ral body were immersed in sodium hypochlorite solution to corrode the
bone marrow. Atrophy of trabeculae and increased spacing between trabe
culae were evaluated semiquantitatively under stereoscopic microscopy.
The authors examined the relation between the semiquantitative data f
ound in the autopsy vertebrae and the patterns and frequencies of each
deformity of the second lumbar vertebrae in 99 patients with involuti
onal osteoporosis. Results. The most frequent vertebral deformity was
wedge-shaped vertebrae with compression of the anterosuperior portion,
and the alterations of the trabecular structure of the anterosuperior
portion were severe and closely related to aging. Severe trabecular a
lterations with no relation to aging did not necessarily cause vertebr
al deformity. Conclusions. Trabecular abnormality, which is significan
tly correlated with aging, may be the necessary and sufficient conditi
on for vertebral deformities in involutional osteoporosis.