The Journal of Bone and Joint Surgery, Vol 67, Issue 8 1206-1214, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
Prediction of vertebral body compressive fracture using quantitative computed tomography
RJ McBroom, WC Hayes, WT Edwards, RP Goldberg and AA White
We performed quantitative computed tomography in vitro on the first and
third lumbar vertebrae in human cadavera using a dibasic potassium
phosphate phantom for calibration. The quantitative computed-tomography
numbers exhibited a significant positive correlation (R2 = 0.89, p less
than 0.0001) with direct measurements of the apparent density of the
vertebral trabecular bone. We also conducted uniaxial compression tests to
failure of the vertebral bodies after removal of the posterior elements,
and found that vertebral compressive strength was also correlated at a high
level of significance (R2 = 0.82, p less than 0.0001) with direct
measurement of the trabecular apparent density. These findings suggested
the possibility that the quantitative computed-tomography values might be
directly predictive of vertebral compressive strength. However, when we
correlated the quantitative computed-tomography values directly with
vertebral compressive strength, the results (R2 = 0.46, p less than 0.061)
were suggestive but not quite significant. All vertebral bodies failed by
compression of the end-plate, suggesting only a modest structural role for
the cortical shell under these loading conditions. This was confirmed by
comparing the compressive load to failure of twenty additional pairs of
vertebrae that were tested with and without an intact vertebral cortex.
Removal of the cortex was associated with approximately 10 per cent
reduction in vertebral load to failure.
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