Abstract
Spinal bone densitometry allows accurate and precise measurement of the severity of bone loss. Where densitometry is not yet available medical practitioners have to continue to rely on clinical radiography. Since the grey levels of the radiographic image are highly inaccurate we studied the radiographic vertebral trabecular pattern for its suitability as a semiquantitative assessment of vertebral bone loss. We defined four vertebral trabecular pattern indices (VTPI 4=normal, VTPI 1=severe bone loss) and tested these for correlations with the prevalence of vertebral fractures, and with spinal and hip bone mineral density measured by dual-energy X-ray absorptiometry (DXA). We found negative correlations between VTPI and the percentage of patients with vertebral fractures (p=0.0001), between VTPI and the number of vertebral fractures per patient (r=0.606,p=0.001) and between VTPI and the severity of vertebral fractures, and a positive correlation between VTPI and spinal (r 2=0.556,p=0.0001) and hip DXA values (r 2=0.315,p=0.0001). We conclude that the vertebral trabecular pattern index can be used to assess the severity of spinal bone loss when a bone densitometer is not available.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Reinbold WD, Genant HK, Reiser UJ, Harris ST, Ettinger G. Bone mineral content in early-postmenopausal and postmenopausal osteoporotic women: comparison of measurement methods. Radiology 1986;160:469–78.
Ruegsegger P, Durand E, Dambacher MA. Localization of regional forearm bone loss from high resolution computed tomography images. Osteoporosis Int 1991;1:76–80.
Kelly TL, Slovik DM, Schoenfeld DA, Neer RM. Quantitative digital radiography versus dual photon absorptiometry of the lumbar spine. J Clin Endocrinol Metab 1988;67:839–44.
Cann CE, Genant HK, Kolb FO, Ettinger B. Quantitative computed tomography for prediction of vertebral fracture risk. Bone 1985;6:1–7.
Lachman E. Osteoporosis: the potentialities and limitations of its roentgenologic diagnosis. AJR 1955;74:712–5.
Meema E. Improved vertebral fracture threshold in postmenopausal osteoporosis by radiogrametric measurements: its usefulness in selection for preventive therapy. J Bone Miner Res 1991;6:9–14.
Singh M, Riggs BL, Beabout JW, Jowsey J. Femoral trabecular pattern index for evaluation of spinal osteoporosis: a detailed methodologic description. Mayo Clin Proc 1973;48: 184–9.
Smith-Bindman R, Cummings SR, Steiger P, Genant HK. A comparison of morphometric definitions of vertebral fracture. J Bone Miner Res 1991;6:25–34.
Eastell R, Cedel SL, Wahner HW, Riggs BL, Melton LJ III. Classification of vertebral fractures. J Bone Miner Res 1991;6:207–15.
Gallagher JC, Hedlund LR, Stoner S, Meeger C. Vertebral morphometry: normative data. Bone Miner 1988;4:189–96.
Mosekilde L. Age-related changes in vertebral trabecular bone architecture: assessed by a new method. Bone 1988;9:247–50.
Arnold JS. Trabecular pattern and shapes in aging and osteoporosis. In: Jee WSS, Parfitt AM, editors. Bone histomorphometry. Third international workshop, Sun Valley, 28 May to 2 June 1980. Paris: Société Nouvelle de Publications M édicates et Dentaires, 1981:297–308.
Atkinson PJ. Variation in trabecular structure of vertebrae with age. Calcif Tissue Res 1967;1:24–32.
Bergot C, Preteux F, Laval-Jeantet AM. Quantitative image analysis of thin sagittal and transversal slices from autopsy specimens of L3 vertebrae. In: Christiansen C, Johansen JS, Riis BJ, editors. Osteoporosis 1987. Copenhagen: Osteopress ApS, 1987:338–40.
Jensen KS, Moselkilde Li, Mosekilde Le. A model of vertebral trabecular bone architecture and its mechanical properties. Bone 1990;11:417–23.
Preteux F, Bergot C, Laval-Jeantet AM. Automatic quantification of vertebra cancellous bone remodeling during aging. Anat Clin 1985;7:203–8.
Amstutz HC, Sissons HA. The structure of the vertebral spongiosa. J Bone Joint Surg [B] 1969;51:540–50.
Casuccio C. An introduction to the study of osteoporosis. (Biomechanical and biophysical research in bone ageing.) Proc R Soc Med 1962;55:663–8.
Lloyd E, Hodges D. Quantitative characterization of bone: a computer analysis of microradiographs. Clin Orthop Rel Res 1971;78:230–50.
Parfitt AM. Trabecular bone architecture in the pathogenesis and prevention of fracture. Am J Med 1987;82(Suppl 1B):68–72.
Gibson LF. The mechanical behaviour of cancellous bone. J Biomech 1985;18:317–28.
Bell GH, Dunbar O, Beck JS, Gibb A. Variations in strength of vertebrae with age and their relation to osteoporosis. Calcif Tissue Res 1967;1:75–86.
Schnitzler CM, Pettifor JM, Mesquita JM, Bird MDT, Schnaid E, Smyth AE. Histomorphometry of iliac crest bone in 346 normal black and white South African adults. Bone Miner 1990;10:183–99.
Tanaka Y. A radiographic analysis on human lumbar vertebrae in the aged. Virchows Arch [A] 1975;366:187–201.
Riggs BL, Hodgson SF, Hoffman DL, Kelly PJ, Johnson KA, Taves D. Treatment of primary osteoporosis with fluoride and calcium. J Am Med Assoc 1980;243:446–9.
Schnitzler CM, Sweet MBE, Blumenfeld TS, Isaacson DC. Radiographic features of the spine in fluoride therapy for osteoporosis. J Bone Joint Surg [B] 1987;69:190–194.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Schnitzler, C.M., Pitchford1, D.G.K., Willis1, E.M. et al. Comparison of the radiographic vertebral trabecular pattern with the vertebral fracture prevalence and spinal bone density. Osteoporosis Int 3, 293–299 (1993). https://doi.org/10.1007/BF01637314
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01637314