Axial compressive strength of human vertebrae trabecular bones classified as normal, osteopenic and osteoporotic by quantitative ultrasonometry of calcaneus

Cesar, Reinaldo; Leivas, Tomaz Puga; Pereira, Cesar Augusto Martins; Boffa, Ricardo Simionato; Guarniero, Roberto; Reiff, Rodrigo Bezerra de Menezes; Mandeli, Antônio; Fortulan, Carlos Alberto; Rollo, João Manuel Domingos de Almeida

doi:10.1590/2446-4740.04116

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Original Articles • Res. Biomed. Eng. 33 (2) • Apr-Jun 2017 • https://doi.org/10.1590/2446-4740.04116 copy

Axial compressive strength of human vertebrae trabecular bones classified as normal, osteopenic and osteoporotic by quantitative ultrasonometry of calcaneus

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract Introduction

Biomechanical assessment of trabecular bone microarchitecture contributes to the evaluation of fractures risk associated with osteoporosis and plays a crucial role in planning preventive strategies. One of the most widely clinical technics used for osteoporosis diagnosis by health professionals is bone dual-energy X-ray absorptiometry (DEXA). However, doubts about its accuracy motivate the introduction of congruent technical analysis such as calcaneal ultrasonometry (Quantitative Ultrasonometry - QUS).

Methods

Correlations between Bone Quality Index (BQI), determined by calcaneal ultrasonometry of thirty (30) individuals classified as normal, osteopenic and osteoporotic, and elastic modulus (E) and ultimate compressive strength (UCS) from axial compression tests of ninety (90) proof bodies from human vertebrae trabecular bone, which were extracted from cadavers in the twelfth thoracic region (T₁₂), first and fourth lumbar (L₁ and L₄).

Results

Analysis of variance (ANOVA) showed significant differences for E (p = 0.001), for UCS (p = 0.0001) and BQI. Spearman’s rank correlation coefficient (rho) between BQI and E (r = 0.499) and BQI and UCS (r = 0.508) were moderate.

Discussion

Calcaneal ultrasonometry technique allowed a moderate estimate of bone mechanical strength and fracture risk associated with osteoporosis in human vertebrae.

Keywords
Osteoporosis; Calcaneal ultrasonometry; Trabecular bone; Human vertebra; Axial compression test; Correlation

Parameter	Groups M ± SD (Min - Max)
Parameter	Normal	Osteopenic	Osteoporotic
Age (Year)	65.000 ± 15.549 (47.000 - 87.000)	77.500 ± 9.301 (62.00 - 93.000)	82.500 ± 10.277 (68.000 - 95.000)

BQI	107.167 ± 18.764	72.017 ± 6.518	53.950 ± 5.364
	(77.000 - 133.000)	(60.333 - 80.333)	(41.833 - 60.500)

E (MPa)	134.693 ± 50.999	85.475 ± 32.397	65.119 ± 23.905
	(52.089 - 196.301)	(45.946 - 134.882)	(38.618 - 105.825)

UCS (MPa)	2,270 ± 1.142	1.239 ± 0.476	0.944 ± 0.396
	(0.711 - 4.789)	(0.617 - 1.889)	(0.477 - 1.536)

	ANOVA		Multiple comparations by Tukey Kramer HSD
PARAMETER	p		Groups		p
			Normal	Osteopenic	0.069
Age (Year)	0.009	^* * = Significant difference. Significant for p = 0.01 to 0.05; Very significant p = 0.001 to 0.01; Extremely significant for p < 0.001.	Normal	Osteoporotic	0.008	^* * = Significant difference. Significant for p = 0.01 to 0.05; Very significant p = 0.001 to 0.01; Extremely significant for p < 0.001.
			Osteopenic	Osteoporotic	0.626

			Normal	Osteopenic	0.0001	^* * = Significant difference. Significant for p = 0.01 to 0.05; Very significant p = 0.001 to 0.01; Extremely significant for p < 0.001.
BQI	0.0001	^* * = Significant difference. Significant for p = 0.01 to 0.05; Very significant p = 0.001 to 0.01; Extremely significant for p < 0.001.	Normal	Osteoporotic	0.0001	^* * = Significant difference. Significant for p = 0.01 to 0.05; Very significant p = 0.001 to 0.01; Extremely significant for p < 0.001.
			Osteopenic	Osteoporotic	0.006	^* * = Significant difference. Significant for p = 0.01 to 0.05; Very significant p = 0.001 to 0.01; Extremely significant for p < 0.001.

			Normal	Osteopenic	0.018	^* * = Significant difference. Significant for p = 0.01 to 0.05; Very significant p = 0.001 to 0.01; Extremely significant for p < 0.001.
E (MPa)	0.001	^* * = Significant difference. Significant for p = 0.01 to 0.05; Very significant p = 0.001 to 0.01; Extremely significant for p < 0.001.	Normal	Osteoporotic	0.010	^* * = Significant difference. Significant for p = 0.01 to 0.05; Very significant p = 0.001 to 0.01; Extremely significant for p < 0.001.
			Osteopenic	Osteoporotic	0.456

			Normal	Osteopenic	0.013	^* * = Significant difference. Significant for p = 0.01 to 0.05; Very significant p = 0.001 to 0.01; Extremely significant for p < 0.001.
UCS (MPa)	0.001	^* * = Significant difference. Significant for p = 0.01 to 0.05; Very significant p = 0.001 to 0.01; Extremely significant for p < 0.001.	Normal	Osteoporotic	0.001	^* * = Significant difference. Significant for p = 0.01 to 0.05; Very significant p = 0.001 to 0.01; Extremely significant for p < 0.001.
			Osteopenic	Osteoporotic	0.657

Variables		r
BQI	Age (Year)	-0.501
BQI	E (MPa)	0.499
BQI	UCS (MPa)	0.508
E (MPa)	Age (Year)	-0.584
UCS (MPa)	Age (Year)	-0.684

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[1] *Corresponding author: Department of Mechanical Engineering, São Carlos School of Engineering, University of São Paulo – USP, Av. Trabalhador São-Carlense, 400, Parque Arnold Schimidt, CEP 13566-590, São Carlos, SP, Brazil. E-mail: rcesar@sc.usp.br