VERTEBRAL FRAGILITY AND STRUCTURAL REDUNDANCY
A.J. Fields, S. Nawathe, S.K. Eswaran, M.G. Jekir, M.F. Adams, P. Papadopoulos, and T.M. Keaveny J. Bone Mineral Res., 27, pp. 2152-2158, (2012)

Abstract
The mechanisms of age-related vertebral fragility remain unclear, but may be related to the degree of “structural redundancy” of the vertebra, that is, its ability to safely redistribute stress internally after local trabecular failure from an isolated mechanical overload. To better understand this issue, we performed biomechanical testing and non-linear micro-CT-based finite element analysis on 12 elderly human thoracic ninth vertebral bodies (ages 76.9 ± 10.8 years). After experimentally overloading the vertebrae to measure strength, we used the nonlinear finite element analysis to estimate the amount of failed tissue and understand failure mechanisms. We found that the amount of failed tissue per unit bone mass decreased with decreasing bone volume fraction (r2 = 0.66, p < 0.01). Thus, for the weak vertebrae with low bone volume fraction, overall failure of the vertebra occurred after failure of just a tiny proportion of the bone tissue (< 5%). This small proportion of failed tissue had two sources: the existence of fewer vertically oriented load paths to which load could be redistributed from failed trabeculae; and the vulnerability of the trabeculae in these few load paths to undergo bending-type failure mechanisms, which further weaken the bone. Taken together, these characteristics suggest that diminished structural redundancy may be an important aspect of age-related vertebral fragility: vertebrae with low bone volume fraction are highly susceptible to collapse since so few trabeculae are available for load redistribution if the external loads cause any trabeculae to fail.


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