Publications by authors named "Paul M Fein"

The spatial heterogeneity in trabecular bone density within the vertebral centrum is associated with vertebral strength and could explain why volumetric bone mineral density (vBMD) exhibits low sensitivity in identifying fracture risk. This study evaluated whether the heterogeneity and spatial distribution of trabecular vBMD are associated with prevalent vertebral fracture. We examined the volumetric quantitative computed tomography (QCT) scans of the L vertebra in 148 participants in the Framingham Heart Study Multidetector CT study.

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Unlabelled: The distribution of bone tissue within the vertebra can modulate vertebral strength independently of average density and may change with age and disc degeneration. Our results show that the age-associated decrease in bone density is spatially non-uniform and associated with disc health, suggesting a mechanistic interplay between disc and vertebra.

Purpose: While the decline of bone mineral density (BMD) in the aging spine is well established, the extent to which age influences BMD distribution within the vertebra is less clear.

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Article Synopsis
  • - The study explores the relationship between intradiscal pressure (IDP) in the intervertebral disc (IVD) and bone density in nearby vertebrae, particularly how this relationship changes between healthy and degenerated discs.
  • - Researchers measured bone density in various bone regions adjacent to the IVD using quantitative computed tomography in 61 spine segments, along with IDP in 26 segments during different postures.
  • - Findings indicate no significant correlation between bone density and IDP, although both showed regional decreases with disc degeneration, suggesting complex interactions between mechanical forces and disc health.
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The biomechanical mechanisms leading to vertebral fractures are not well understood. Clinical and laboratory evidence suggests that the vertebral endplate plays a key role in failure of the vertebra as a whole, but how this role differs for different types of vertebral loading is not known. Mechanical testing of human thoracic spine segments, in conjunction with time-lapsed micro-computed tomography, enabled quantitative assessment of deformations occurring throughout the entire vertebral body under axial compression combined with anterior flexion ("combined loading") and under axial compression only ("compression loading").

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