Axial compressive strength of human vertebrae trabecular bones classified as normal, osteopenic and osteoporotic by quantitative ultrasonometry of calcaneus

Abstract Introduction Biomechanical assessment of trabecular bone microarchitecture contributes to the evaluation of fractures risk associated with osteoporosis and plays a crucial role in planning preventive strategies. One of the most widely clinical technics used for osteoporosis diagnosis by health professionals is bone dual-energy X-ray absorptiometry (DEXA). However, doubts about its accuracy motivate the introduction of congruent technical analysis such as calcaneal ultrasonometry (Quantitative Ultrasonometry - QUS). Methods Correlations between Bone Quality Index (BQI), determined by calcaneal ultrasonometry of thirty (30) individuals classified as normal, osteopenic and osteoporotic, and elastic modulus (E) and ultimate compressive strength (UCS) from axial compression tests of ninety (90) proof bodies from human vertebrae trabecular bone, which were extracted from cadavers in the twelfth thoracic region (T12), first and fourth lumbar (L1 and L4). Results Analysis of variance (ANOVA) showed significant differences for E (p = 0.001), for UCS (p = 0.0001) and BQI. Spearman’s rank correlation coefficient (rho) between BQI and E (r = 0.499) and BQI and UCS (r = 0.508) were moderate. Discussion Calcaneal ultrasonometry technique allowed a moderate estimate of bone mechanical strength and fracture risk associated with osteoporosis in human vertebrae.

摘要 引言
骨小梁微结构的生物力学评估有助于评估骨质疏松相关骨折风险，并对制定预防策略具有关键作用。医疗从业者用于骨质疏松诊断的最常用临床技术之一为双能X线吸收测定法（dual-energy X-ray absorptiometry, DEXA）。然而，其准确性存疑，这推动了跟骨超声测定法（定量超声骨量分析，Quantitative Ultrasonometry, QUS）这类等效技术分析方法的应用。
方法
本研究针对30名被分为骨量正常、骨量减少及骨质疏松的受试者，通过跟骨超声测定得到骨质量指数（Bone Quality Index, BQI）；同时对90个取自第十二胸椎（T12）、第一及第四腰椎（L1和L4）的尸体人椎体骨小梁试样开展轴向压缩试验，获取其弹性模量（E）与抗压极限强度（ultimate compressive strength, UCS），并对上述指标进行相关性分析。
结果
方差分析（Analysis of variance, ANOVA）结果显示，弹性模量（p=0.001）、抗压极限强度（p=0.0001）及骨质量指数均存在显著性差异。骨质量指数与弹性模量（r=0.499）、骨质量指数与抗压极限强度（r=0.508）之间的斯皮尔曼等级相关系数（rho）均呈中等程度相关。
讨论
跟骨超声测定技术可对人椎体的骨机械强度及骨质疏松相关骨折风险进行中等程度的评估。