Background: Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength due to a\nreduction of bone mass and deterioration of bone microstructure predisposing an individual to an increased risk\nof fracture. Trabecular bone microstructure analysis and finite element models (FEM) have shown to improve the\nprediction of bone strength beyond bone mineral density (BMD) measurements. These computational methods\nhave been developed and validated in specimens preserved in formalin solution or by freezing. However, little\nis known about the effects of preservation on trabecular bone microstructure and FEM. The purpose of this\nobservational study was to investigate the effects of preservation on trabecular bone microstructure and FEM in\nhuman vertebrae.\nMethods: Four thoracic vertebrae were harvested from each of three fresh human cadavers (n = 12). Multi-detector\ncomputed tomography (MDCT) images were obtained at baseline, 3 and 6 month follow-up. In the intervals between\nMDCT imaging, two vertebrae from each donor were formalin-fixed and frozen, respectively. BMD, trabecular bone\nmicrostructure parameters (histomorphometry and fractal dimension), and FEM-based apparent compressive modulus\n(ACM) were determined in the MDCT images and validated by mechanical testing to failure of the vertebrae after\n6 months.\nResults: Changes of BMD, trabecular bone microstructure parameters, and FEM-based ACM in formalin-fixed and\nfrozen vertebrae over 6 months ranged between 1.0ââ?¬â??5.6 % and 1.3ââ?¬â??6.1 %, respectively, and were not statistically\nsignificant (p > 0.05). BMD, trabecular bone microstructure parameters, and FEM-based ACM as assessed at baseline,\n3 and 6 month follow-up correlated significantly with mechanically determined failure load (r = 0.89ââ?¬â??0.99; p < 0.05).\nThe correlation coefficients r were not significantly different for the two preservation methods (p > 0.05).\nConclusions: Formalin fixation and freezing up to six months showed no significant effects on trabecular bone\nmicrostructure and FEM-based ACM in human vertebrae and may both be used in corresponding in-vitro experiments\nin the context of osteoporosis.
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