The effect of osteoporotic vertebral fracture of predicted spinal loads in vivo

Briggs, Andrew, Wrigley, Tim, Dieen, Jaap, Phillips, Bev, Lo, Sing Kai, Greig, Alison and Bennell, Kim 2006, The effect of osteoporotic vertebral fracture of predicted spinal loads in vivo, European spinal journal, vol. 15, no. 12, pp. 1785-1795, doi: 10.1007/s00586-006-0158-0.

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Title The effect of osteoporotic vertebral fracture of predicted spinal loads in vivo
Author(s) Briggs, Andrew
Wrigley, Tim
Dieen, Jaap
Phillips, Bev
Lo, Sing Kai
Greig, Alison
Bennell, Kim
Journal name European spinal journal
Volume number 15
Issue number 12
Start page 1785
End page 1795
Publisher Springer-Verlag
Place of publication Berlin, Germany
Publication date 2006-12
ISSN 0940-6719
Keyword(s) osteoporosis
vertebral fracture
spine loading
Summary he aetiology of osteoporotic vertebral fractures is multi-factorial, and cannot be explained solely by low bone mass. After sustaining an initial vertebral fracture, the risk of subsequent fracture increases greatly. Examination of physiologic loads imposed on vertebral bodies may help to explain a mechanism underlying this fracture cascade. This study tested the hypothesis that model-derived segmental vertebral loading is greater in individuals who have sustained an osteoporotic vertebral fracture compared to those with osteoporosis and no history of fracture. Flexion moments, and compression and shear loads were calculated from T2 to L5 in 12 participants with fractures (66.4 ± 6.4 years, 162.2 ± 5.1 cm, 69.1 ± 11.2 kg) and 19 without fractures (62.9 ± 7.9 years, 158.3 ± 4.4 cm, 59.3 ± 8.9 kg) while standing. Static analysis was used to solve gravitational loads while muscle-derived forces were calculated using a detailed trunk muscle model driven by optimization with a cost function set to minimise muscle fatigue. Least squares regression was used to derive polynomial functions to describe normalised load profiles. Regression co-efficients were compared between groups to examine differences in loading profiles. Loading at the fractured level, and at one level above and below, were also compared between groups. The fracture group had significantly greater normalised compression (p = 0.0008) and shear force (p < 0.0001) profiles and a trend for a greater flexion moment profile. At the level of fracture, a significantly greater flexion moment (p = 0.001) and shear force (p < 0.001) was observed in the fracture group. A greater flexion moment (p = 0.003) and compression force (p = 0.007) one level below the fracture, and a greater flexion moment (p = 0.002) and shear force (p = 0.002) one level above the fracture was observed in the fracture group. The differences observed in multi-level spinal loading between the groups may explain a mechanism for increased risk of subsequent vertebral fractures. Interventions aimed at restoring vertebral morphology or reduce thoracic curvature may assist in normalising spine load profiles.
Language eng
DOI 10.1007/s00586-006-0158-0
Field of Research 110399 Clinical Sciences not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2006, Springer-Verlag
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Document type: Journal Article
Collections: Faculty of Health
School of Health and Social Development
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