Skip to main content
SpringerLink
Log in

Relative contribution of vertebral body and posterior arch in female and male lumbar spine peak bone mass

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Peak bone mass (PBM) is an important reference value in the diagnosis of osteoporosis. It is usually established by determining the areal bone mineral density (BMD in g/cm2) for a given site of the skeleton in young healthy adults. This measurement takes into account both the thickness and the integrated mineral density of the bone scanned. It should therefore be a major determinant of the resistance to mechanical stress. However, in lumbar spine the mean BMD as determined by dual-energy either isotopic or X-ray (DXA) absorptiometry in antero-posterior (ap) view was repeatedly found not to be different between male and female young healthy adults despite the greater volume of lumbar vertebral bodies in males. A greater contribution of the posterior vertebral arch to areal BMD-ap in females than in males could account for such an apparent discrepancy. In order to clarify this issue we have determined in 65 (32 male and 33 female) young healthy adults aged 20–35 years the relative contribution of the vertebral body (VB) and posterior vertebral arch (VA) to BMD and bone mineral content (BMC) of L2–3 measured by both antero-posterior and lateral (lat) scanning using DXA. In young healthy adults mean BMC in antero-posterior view was found not to be significantly different from the total BMC determined by lateral scanning including both VB and VA. This allowed us then to calculate the VA BMC by substracting VB BMC-lat from BMC-ap. The results indicated that the mean value for males was significantly greater than that for females for BMC-ap (male/female ratio (mean±SEM): 1.16±0.05,p<0.01), BMC-lat (1.38±0.07,p<0.001) and VB BMD-lat (1.16±0.04,p<0.001). In sharp contrast, no sex difference was found in BMD-ap (male/female ratio: 0.99±0.03) and VA BMC (male/female ratio: 0.97±0.06). VA BMC represented 44% and 53% (p<0.001) of BMC-ap in males and females, respectively. Furthermore, in neither sex was any correlation between VA BMC and VB BMC found. In summary, this study indicates that the relative contribution of the posterior vertebral arch to the bone mineral content of L2–3 is significantly smaller in males than in females. This difference could partly explain the absence of a sex difference in areal BMD as measured in antero-posterior view. In agreement with lumbar anthropomorphometric data this study further shows that the sex difference in vertebral body size, an important component in mechanical resistance, is expressed when areal BMD is measured in lateral but not in antero-posterior scanning. Finally, the data analysis underlines the quantitative importance of the vertebral arch in the value of areal BMD as measured by DXA in the classical antero-posterior view, and demonstrates the absence of a significant quantitative relationship between the bone mineral content of the vertebral body and that of the posterior vertebral arch.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Johnston CC, Melton LJ, Lindsay R, Eddy DM. Clinical indication for bone mass measurements: a report from the Scientific Advisory board of the National Osteoporosis Foundation. J Bone Miner Res 1989;4 Suppl 2:1–28.

    Google Scholar 

  2. Genant HK, Steiger P, Faulkner KG, Majumbar S, Lang P, Glër CC. Non-invasive bone mineral analysis: recent advances and future directions. In: Christiansen C, Overgaard K, editors. Osteoporosis 1990. Copenhagen: 435–47.

  3. Slosman DO, Rizzoli R, Buchs B, Piana F, Donath A, Bonjour JP. Comparative study of the performance of X-ray and gadolinium-153 bone densitometers at the level of the spine, femoral neck and femoral shaft. Eur J Nucl Med 1990;17:3–9.

    Google Scholar 

  4. Melton JL, Chao E, Lane J. Biomechanical aspects of fractures. In: Riggs L, Melton LJ, editors. Osteoporosis: etiology, diagnosis and management. New York: Raven Press, 1988.

    Google Scholar 

  5. Einhorn TA. Bone strength: the bottom line. Calcif Tissue Int 1992;51:333–9.

    Google Scholar 

  6. Vesterby A, Mosekilde L, Gundersen JG, Melson F, Mosekilde L, Holme K, S ørensen S. Biologically meaningful determinants of the in vitro strength of lumbar vertebrae. Bone 1991;12:219–24.

    Google Scholar 

  7. Martin BR. Determinants of the mechanical properties of bone. J Biomech 1991;24:79–88.

    Google Scholar 

  8. Melton LJ, Kan SH, Wahner HW, Riggs BL. Lifetime fracture risk: an approach to hip fracture risk assessment based on bone mineral density and age. J Clin Epidemiol 1988;41:985–94.

    Google Scholar 

  9. Black DM, Cummings SR, Genant HK, Nevitt MC, Palermo L, Browner W. Axial and appendicular bone density predict fractures in older women. J Bone Miner Res 1992;7:633–8.

    Google Scholar 

  10. Hui SL, Johnston CC, Mazess RB. Bone mass in normal children and young adults. Growth 1985;49:34–43.

    Google Scholar 

  11. Geusens P, Dequeker J, Verstraeten A, Nijs J. Age-, sex-, and menopause-related changes of vertebral and peripheral bone: population study using dual and single photon absorptiometry and radiogrammetry. J Nucl Med 1986;27:1540–9.

    Google Scholar 

  12. Bonjour JP, Theintz G, Buchs B, Slosman D, Rizzoli R. Critical years and stages of puberty for spinal and femoral bone mass accumulation during adolescence. J Clin Endocrinol Metab 1991;73:555–63.

    Google Scholar 

  13. Buchs B, Rizzoli R, Slosman D, Nydegger V, Bonjour JP. Densité minérale osseuse de la colonne lombaire, du col et de la diaphyse fémoraux d'un échantillon de la population genevoise. Schweiz Med Wochenschr 1992;122:1129–36.

    Google Scholar 

  14. Genant HK, Cann CE, Pozzi-Mucelli RS, Kanter AS. Vertebral mineral determination by quantitative CT: clinical feasibility and normative data. J Comput Assist Tomogr 1983;7:554.

    Google Scholar 

  15. Gilsanz V, Gibbens DT, Roe TF, Carlson M, SenacMO, Boechat MI, et al. Vertebral bone density in children: effect of puberty. Radiology 1988;166:847–50.

    Google Scholar 

  16. Kalender WA, Felsenberg D, Louis O, Lopez P, Osteaux M, Fraga J. Reference values for trabecular and cortical vertebral bone density in single-and dual-energy quantitative computed tomography. Eur J Radiol 1989;9:75–80.

    Google Scholar 

  17. Kelly PJ, Twoney L, Sambrook PN, Eisman JA. Sex differences in peak adult bone mineral density. J Bone Miner Res 1990;5:1169–75.

    Google Scholar 

  18. Arnold JS. Amount and quality of trabecular bone in osteo-porotic vertebral fractures. J Clin Endocrinol Metab 1973;2:221–38.

    Google Scholar 

  19. Dunhill MS, Anderson JA, Whitehead R. Quantitative histo-logical studies on age changes in bone. J Pathol Bacteriol 1967;94:275–91.

    Google Scholar 

  20. Mosekilde L, Mosekilde L. Sex differences in age-related changes in vertebral body size, density and biochemical competence in normal individuals. Bone 1990;11:67–73.

    Google Scholar 

  21. Aharinejad S, Bertagnoli R, Wicke K, Firbas W, Schneider B. Morphometric analysis of vertebrae and intervertebral discs as a basis of disc replacement. Am J Anat 1990;189:69–76.

    Google Scholar 

  22. Scoles PV, Linton AE, Latimer B, Levy ME, Digiovanni BF. Vertebral body and posterior element morphology: the normal spine in middle life. Spine 1988;13:1082–6.

    Google Scholar 

  23. Berry JL, Moran JM, Berg WS, Steffee AD. A morphometric study of human lumbar and selected thoracic vertebrae. Spine 1987;12:362–7.

    Google Scholar 

  24. Minne HW, Leidig G, Wüster C, Siromachkostov L, Baldauf G, Bickel R, et al. A newly developed spine deformity index (SDI) to quantitate vertebral crush fractures in patients with osteoporosis. Bone Miner 1988;3:335–49.

    Google Scholar 

  25. Uebelhart D, Duboeuf F, Meunier PJ, Delmas PD. Lateral dual-photon absorptiometry: a new technique to measure the bone mineral density at the lumbar spine. J Bone Miner Res 1990;5:525–31.

    Google Scholar 

  26. Slosman DO, Rizzoli R, Donath A, Bonjour JP. Vertebral bone mineral density measured laterally by dual-energy X-ray absorptiometry. Osteoporosis Int 1990;1:23–9.

    Google Scholar 

  27. Rupich R, Pacifici R, Griffin M, Vered I, Susman N, Avioli LV. Lateral dual energy radiography: a new method for measuring vertebral bone density: a preliminary study. J Clin Endocrinol Metab 1990;70:1768–70.

    Google Scholar 

  28. Larnach TA, Boyd SJ, Smart RC, Buttler SP, Rohl PG, Diamond TH. Reproducibility of lateral spine scans using dual energy X-ray absorptiometry. Calcif Tissue Int 1992;52:255–8.

    Google Scholar 

  29. Glanz SA, Slinker BK. Primer of applied regression and analysis of variance. Singapore McGraw-Hill, 1990.

  30. Lentner C, editor. Geigy scientific tables. Basle, 1982.

  31. Mazess RB, Gifford CA, Bisek JP, Barden HS, Hanson JA. DEXA measurement of spine density in the lateral projection. I. Methodology. Calcif Tissue Int 1991;49:235–9.

    Google Scholar 

  32. Nottestad SY, Baumel JJ, Kimmel DB, Recker RR, Heaney RP. The proportion of trabecular bone in human vertebrae. J Bone Miner Res 1987;2:221–9.

    Google Scholar 

  33. Louis O, Van Den Winkel P, Covens P, Schoutens P, Osteaux M. Dual-energy X-ray absorptiometry of lumbar vertebrae: relative contribution of body and posterior elements and accuracy in relation with neutron activation analysis. Bone 1992;13:317–20.

    Google Scholar 

  34. Stagnara P, De Mauroy JC, Dran G, Gonon GP, Costanzo G, Dimnet J, Pasquet A. Reciprocal angulation of vertebral bodies in a sagittal plane: approach to references for the evaluation of kyphosis and lordosis. Spine 1982;7:335–42.

    Google Scholar 

  35. Fernand R, Fox DE. Evaluation of lumbar lordosis: a prospective and retrospective study. Spine 1985;10:799–803.

    Google Scholar 

  36. Carr AJ, Jeffersn RJ, Turner-Smith AR, Beavis A. An analysis of normal back shape measured by ISIS scanning. Spine 1991;16:656–9.

    Google Scholar 

  37. Gallagher JC, Hedlund LR, Stoner S, Meeger C. Vertebral morphometry: normative data. Bone Miner 1988;4:189–96.

    Google Scholar 

  38. 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.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Clinical Pathophysiology, WHO Collaborating Centre for Osteoporosis and Bone Disease, Department of Medicine, University Hospital, Geneva, Switzerland

    P. -E. Fournier, R. Rizzoli, B. Buchs &  J. -P. Bonjour MD

  2. Division of Nuclear Medicine, Department of Radiology, University Hospital, Geneva, Switzerland

    D. O. Slosman

Authors
  1. P. -E. Fournier
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Rizzoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. O. Slosman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. B. Buchs
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. -P. Bonjour MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fournier, P.E., Rizzoli, R., Slosman, D.O. et al. Relative contribution of vertebral body and posterior arch in female and male lumbar spine peak bone mass. Osteoporosis Int 4, 264–272 (1994). https://doi.org/10.1007/BF01623350

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01623350

Keywords

Search

Navigation