Subscribe to RSS
DOI: 10.1055/a-0997-8059
Vergleich der Spongiosamorphologie aus humaner Halswirbelsäule (HWS), Brustwirbelsäule (BWS) und Lendenwirbelsäule (LWS) einer 102-jährigen Körperspenderin
Comparison of the spongiosamorphology of the human cervical spine (CS), thoracic spine (TS) and lumbar spine (LS) of a 102-year-old body donorPublication History
08/07/19
08/15/19
Publication Date:
14 November 2019 (online)
Zusammenfassung
Osteoporose-typische Frakturen treten nicht in der Halswirbelsäule auf. Knochenhistologische und QCT-Untersuchungen zeigen eine höhere trabekuläre Dichte in der HWS im Vergleich zu den anderen Wirbelsäulenabschnitten. Mikro-CT-Untersuchungen (µ-CT) aller Wirbelkörper zu dieser Problematik sind uns nicht bekannt. Das Ziel der vorliegenden Untersuchung war der Vergleich von Spongiosa aus allen 24 Wirbelkörpern vom HWK 1 bis zum LWK 5 einer 102-jährigen Körperspenderin hinsichtlich Knochenmineralgehalt (KMG), Trabekeldicke (Tb.Th.) und deren Separation (Tb.Sp.). Mittels Jamshidi-Nadel® wurden die Proben gewonnen. Anschließend erfolgte eine µ-CT Analyse. Der höchste KMG fand sich in der HWS (81,8 ± 37,4 mg/cm3). Der Unterschied zu den anderen Abschnitten der Wirbelsäule – BWS (30,9 ± 27,0 mg/cm3, p = 0,005) und LWS (30,9 ± 19,4 mg/cm3, p = 0,048) war statistisch signifikant. Der Vergleich der Werte zwischen BWS und LWS ergab keinen signifikanten Unterschied (p > 0,05). Bezüglich der Tb. Th. und der Tb. Sp. in HWS, BWS und LWS ließen sich keine signifikanten Unterschiede feststellen (p > 0,05). Auch im Einzelfall einer 102-jährigen ist der mittels µ-CT gemessene KMG der HWS signifikant höher als in den anderen Wirbelsäulenabschnitten.
Abstract
Osteoporotic fractures do not typically occur in the cervical vertebrae. Prior investigations using QCT and bone histology have revealed a higher trabecular bone thickness in cervical vertebrae compared to thoracic and lumbar vertebrae. An examination of the vertebrae using Micro-CT, with respect to this question, has not been previously reported.
The aim of this study was to compare the spongiosa, in terms of bone density (BMD), trabecular thickness (Tb. Th.) and separation (Tb. Sp.), from all 24 vertebral bodies (C1 to L5) from a 102-year-old body donor with known osteoporosis. Using a Jamshidi Needle® samples were taken from the vertebral bodies. These were analysed using Micro-CT. The BMD of the cervical spine (81.8 ± 37.4 mg/cm3) was markedly higher than in the thoracic (30.9 ± 27.0 mg/cm3) and lumbar (30.9 ± 19.4 mg/cm3) vertebrae. A pairwise comparison of the BMD showed a significant difference between cervical spine and thoracic spine (p = 0.005) and also between cervical and lumbar spine (p = 0.048). No differences were found in the trabecular thickness or trabecular separation between the three sections of the spinal column.
The BMD of the cervical spine was shown to be markedly greater than in the thoracic and lumbar spine of this very elderly patient.
-
Literatur
- 1 Karlsson MK, Kherad M, Hasserius R. et al. Characteristics of Prevalent Vertebral Fractures Predict New Fractures in Elderly Men, The Journal of bone and joint surgery. American volume 2016; 98: 379-385
- 2 Ismail AA, Cooper C, Felsenberg D. et al. Number and type of vertebral deformities. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 1999; 9: 206-213
- 3 Waterloo S, Ahmed LA, Center JR. et al. Prevalence of vertebral fractures in women and men in the population-based Tromsø Study. BMC Musculoskeletal Disorders 2012; 13: 3
- 4 Grote HJ, Amling M, Vogel M. et al. Intervertebral variation in trabecular microarchitecture throughout the normal spine in relation to age. Bone 1995; 16: 301-308
- 5 Moroney SP, Schultz AB, Miller JA. Analysis and measurement of neck loads. Journal of orthopaedic research : official publication of the Orthopaedic Research Society 1988; 6: 713-720
- 6 Riis BJ. The role of bone loss. The American Journal of Medicine 1995; 98: 29S-32S
- 7 Uhl M, Theves C, Geiger J. et al. The percutaneous bone biopsy. Zeitschrift fur Orthopadie und Unfallchirurgie 2009; 147: 327-333
- 8 Park E-A, Hong SH, Kim KG. et al. Experimental bone biopsies using two bone biopsy needles. Academic radiology 2009; 16: 332-340
- 9 Andresen R, Radmer S, Banzer D. et al. The quantitative determination of bone mineral content-a system comparison of similarly built computed tomographs. RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin 1994; 160: 260-265
- 10 Genant HK, Wu CY, van Kuijk C. et al. Vertebral fracture assessment using a semiquantitative technique. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research 1993; 8: 1137-1148
- 11 Huelke DF, Nusholtz GS. Cervical spine biomechanics. Journal of orthopaedic research : official publication of the Orthopaedic Research Society 1986; 4: 232-245
- 12 Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 1994; 4: 368-381