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Analysis of Cortical Bone Structures in Perimenopausal Female Patients With Recent Fragility Fractures
406
Abstracts
P110
41.50.3 cm3 sized scaffold were implanted on each side of the L5-6 intertransverse-process space. In the undifferentiated MSC group (n54), the rabbits were implanted with the same sized scaffolds impregnated with 1.0108 allogeneic rabbit bone marrow-derived undifferentiated MSCs at the same sites as described above. In the control group (n54), the rabbits were implanted with scaffolds alone. The spinal fusion results were assessed with 3-D CT scanning and the DXA examination for BMD analysis. Results: Of our rabbits, the surgical results revealed that the MSC groups had better bone fusion than the control group. In addition, the mean BMD of the bone fusion mass was 0.15775 g/cm2 in the differentiated MSC group, 0.14625 g/cm2 in the undifferentiated MSC group, and 0.11 g/cm2 in the control group.
ANALYSIS OF CORTICAL BONE STRUCTURES IN PERIMENOPAUSAL FEMALE PATIENTS WITH RECENT FRAGILITY FRACTURES T. Stanek1,*, R. Kocijan1, C. Muschitz1, J. Patsch2, A. Zendeli1, J. Haschka1, H. Resch1; 1Medical Department II, The Vinforce Study Group - St. Vincent Hospital, Vienna Austria, 2CIR Lab, Department of Radiology, Medical University Vienna Austria, Vienna, Austria Aims: The aim of this study was to investigate trabecular and cortical bone microstructure in perimenopausal patients with atraumatic peripheral or vertebral fractures. We hypothesize that in perimenopausal women cortical bone is more affected by osteoporosis than trabecular bone. Methods: We consecutively investigated 26 perimenopausal treatment naive female patients (mean age: 47.8 yrs) with peripheral fractures (PG) and compared them to age- and sex-matched healthy controls (CG; n538; mean age 42.7 yrs). Patients had an average of two atraumatic fractures, but were otherwise healthy. The distal radius and the ultradistal tibia of all patients were scanned on an HRpQCT scanner (XtremeCT, SCANCO Medical, Br€uttisellen, Switzerland). Trabecular bone volume fraction (BV/TV) from the volumetric BMD of the trabecular compartment (Tb.BMD), the peripheral region adjacent to the cortex (pTb.BMD) and the central trabecular region (mTb.BMD) were analyzed. From the binary trabecular ridge image, trabecular number (Tb.N) was measured using the direct 3D distance transform approach. Based on the densitometric BV/TV and direct Tb.N, trabecular thickness (Tb.Th) and trabecular separation (Tb.Sp) were derived using traditional plate model assumptions, as has been described previously (Boutroy et al., JCEM 2005). To assess cortical bone microarchitecture, the trabecular and cortical compartment were segmented by automated algorithm (Burghardt et al., JBMR 2009). We analyzed cortical BMD (Ct.BMD), cortical porosity (Ct.Po), cortical pore volume (Ct.Po.V), cortical pore diameter (Ct.Po.Dm) and cortical pore diameter distribution (Ct.Po.Dm.SD). Results: Structural analysis by HR-pQCT showed significant differences between patients and healthy controls regarding cortical but not trabecular parameters at both sites. At the radius patients had increased cortical pore volume (7.744.97mm3 vs. 5.293.78; p!0.01), increased cortical pore diameter (0.170.03mm vs. 0.150.02mm; p! 0.001) and an increased distribution of cortical pore diameters (73% vs. 43%; p!0.01) compared to controls. In addition, at the tibia cortical pore volume (61.1530.66mm3; p!0.01) and also cortical porosity (74% vs. 43%; p!0.01) were significantly increased. Strong correlations of cortical parameters were found between the tibia and radius. In addition, most cortical structure parameters were correlated with age in patients and controls. Conclusion: Our results suggest that bone fragility and fracture susceptibility in perimenopausal females are likely to contribute to poor cortical bone strength and increased cortical porosity. However, HR-pQCT resolution is limited and cortical porosity, analyzed by different algorithm, was reported to be much higher. Disclosure of Interest: None Declared
P111 BONE MINERAL DENSITY IN SPINAL FUSION OF RABBIT BONE MARROW MESENCHYMAL STEM CELLS T.-H. Lee1,*, Y.-H. Huang1, A.-L. Kwan2, W.-C. Lin3, T.-C. Lee1; 1Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 2Neurosurgery, Kaohsiung Medical University Hospital, 3Radiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Kaohsiung, Taiwan Aims: Mesenchymal stem cells (MSCs) are multipotent cells that can replicate and have the potential to differentiate to lineages of mesenchymal tissues, including bone, cartilage and fat1. Osteogenic induction of MSCs for enhancing new bone formation has become a mainstream recently. The aim of the current study was to investigate the results of allogeneic rabbit bone marrow-derived MSCs with and without osteogenic differentiation on spinal fusion. Methods: Twelve rabbits were evenly divided into three groups (with four for each group). In the differentiated MSC group (n54), 1.0108 allogeneic rabbit bone marrow-derived MSCs with osteogenic differentiation loaded on a
Conclusion: The allogeneic rabbit MSCs with and without osteogenic differentiation could promote spinal fusion. The differentiated/undifferentiated MSC groups had higher fusion mass BMD compared to the control group. References: 1. Pittenger MF, et al. Science 1999;284:143. Acknowledgement: The authors are grateful to note that this work had financial support from grants provided by the National Science Council of Taiwan (NSC 98-2314-B-182A-038-MY2 and NSC 100-2314-B-182A-011-MY2). Additional support was provided by Chang Gung Memorial Hospital, Taiwan (CMRPG890981). Disclosure of Interest: None Declared
P112 DIFFERENCE IN SPINE TBS BETWEEN MEN AND WOMEN: REAL OR TECHNICAL? W. D. Leslie1,*, L. Lix2, S. Morin3, S. Majumdar4, D. Hans5; 1Nuclear Medicine, 2 Department of Community Health Sciences, University of Manitoba, Winnipeg, 3 Internal Medicine, McGill University, Montreal, 4Division of General Internal Medicine, University of Alberta, Edmonton, Canada, 5Bone Disease Unit, Lausanne University Hospital, Lausanne, Switzerland Aims: Spine trabecular bone score (TBS) predicts osteoporotic and/or hip fractures in women and men independently of BMD and clinical risk factors. However, TBS software was optimized for women. Prodigy scanners (GE/Lunar) give average TBS values for men that are w13% lower than in women despite men having higher BMD and lower fracture risk. DXA image quality is degraded by soft tissue and also affects texture analysis. We hypothesized that soft tissue X-ray attenuation differences between men and women might account for the paradoxically lower spine TBS in men. We investigated whether sex differences in spine TBS on Prodigy scanners are technical or reflect real texture differences between men and women. Methods: Spine (L1-4) DXA exams (Prodigy, GE/Lunar) were identified in a database containing all clinical results for the Province of Manitoba, Canada. Lumbar spine TBS (TBS iNsightÒ) was derived from each spine DXA examination blinded to clinical parameters. From this database we extracted two matched groups of men and women: Group 1 (matched for age, BMI, scan year, DXA scanner) and Group 2 (matched for spine tissue thickness measured from DXA). Mean group differences were analyzed using t-tests and ANCOVA with FRAX clinical risk factors and prior osteoporosis treatment as covariates. Results: Group 1 contained 3511 matched pairs of men and women, and Group 2 contained 3417 matched pairs of men and women (mean age 68 years, BMI w27
Journal of Clinical Densitometry: Assessment & Management of Musculoskeletal Health
Volume 17, 2014
Abstracts
P110
41.50.3 cm3 sized scaffold were implanted on each side of the L5-6 intertransverse-process space. In the undifferentiated MSC group (n54), the rabbits were implanted with the same sized scaffolds impregnated with 1.0108 allogeneic rabbit bone marrow-derived undifferentiated MSCs at the same sites as described above. In the control group (n54), the rabbits were implanted with scaffolds alone. The spinal fusion results were assessed with 3-D CT scanning and the DXA examination for BMD analysis. Results: Of our rabbits, the surgical results revealed that the MSC groups had better bone fusion than the control group. In addition, the mean BMD of the bone fusion mass was 0.15775 g/cm2 in the differentiated MSC group, 0.14625 g/cm2 in the undifferentiated MSC group, and 0.11 g/cm2 in the control group.
ANALYSIS OF CORTICAL BONE STRUCTURES IN PERIMENOPAUSAL FEMALE PATIENTS WITH RECENT FRAGILITY FRACTURES T. Stanek1,*, R. Kocijan1, C. Muschitz1, J. Patsch2, A. Zendeli1, J. Haschka1, H. Resch1; 1Medical Department II, The Vinforce Study Group - St. Vincent Hospital, Vienna Austria, 2CIR Lab, Department of Radiology, Medical University Vienna Austria, Vienna, Austria Aims: The aim of this study was to investigate trabecular and cortical bone microstructure in perimenopausal patients with atraumatic peripheral or vertebral fractures. We hypothesize that in perimenopausal women cortical bone is more affected by osteoporosis than trabecular bone. Methods: We consecutively investigated 26 perimenopausal treatment naive female patients (mean age: 47.8 yrs) with peripheral fractures (PG) and compared them to age- and sex-matched healthy controls (CG; n538; mean age 42.7 yrs). Patients had an average of two atraumatic fractures, but were otherwise healthy. The distal radius and the ultradistal tibia of all patients were scanned on an HRpQCT scanner (XtremeCT, SCANCO Medical, Br€uttisellen, Switzerland). Trabecular bone volume fraction (BV/TV) from the volumetric BMD of the trabecular compartment (Tb.BMD), the peripheral region adjacent to the cortex (pTb.BMD) and the central trabecular region (mTb.BMD) were analyzed. From the binary trabecular ridge image, trabecular number (Tb.N) was measured using the direct 3D distance transform approach. Based on the densitometric BV/TV and direct Tb.N, trabecular thickness (Tb.Th) and trabecular separation (Tb.Sp) were derived using traditional plate model assumptions, as has been described previously (Boutroy et al., JCEM 2005). To assess cortical bone microarchitecture, the trabecular and cortical compartment were segmented by automated algorithm (Burghardt et al., JBMR 2009). We analyzed cortical BMD (Ct.BMD), cortical porosity (Ct.Po), cortical pore volume (Ct.Po.V), cortical pore diameter (Ct.Po.Dm) and cortical pore diameter distribution (Ct.Po.Dm.SD). Results: Structural analysis by HR-pQCT showed significant differences between patients and healthy controls regarding cortical but not trabecular parameters at both sites. At the radius patients had increased cortical pore volume (7.744.97mm3 vs. 5.293.78; p!0.01), increased cortical pore diameter (0.170.03mm vs. 0.150.02mm; p! 0.001) and an increased distribution of cortical pore diameters (73% vs. 43%; p!0.01) compared to controls. In addition, at the tibia cortical pore volume (61.1530.66mm3; p!0.01) and also cortical porosity (74% vs. 43%; p!0.01) were significantly increased. Strong correlations of cortical parameters were found between the tibia and radius. In addition, most cortical structure parameters were correlated with age in patients and controls. Conclusion: Our results suggest that bone fragility and fracture susceptibility in perimenopausal females are likely to contribute to poor cortical bone strength and increased cortical porosity. However, HR-pQCT resolution is limited and cortical porosity, analyzed by different algorithm, was reported to be much higher. Disclosure of Interest: None Declared
P111 BONE MINERAL DENSITY IN SPINAL FUSION OF RABBIT BONE MARROW MESENCHYMAL STEM CELLS T.-H. Lee1,*, Y.-H. Huang1, A.-L. Kwan2, W.-C. Lin3, T.-C. Lee1; 1Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 2Neurosurgery, Kaohsiung Medical University Hospital, 3Radiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Kaohsiung, Taiwan Aims: Mesenchymal stem cells (MSCs) are multipotent cells that can replicate and have the potential to differentiate to lineages of mesenchymal tissues, including bone, cartilage and fat1. Osteogenic induction of MSCs for enhancing new bone formation has become a mainstream recently. The aim of the current study was to investigate the results of allogeneic rabbit bone marrow-derived MSCs with and without osteogenic differentiation on spinal fusion. Methods: Twelve rabbits were evenly divided into three groups (with four for each group). In the differentiated MSC group (n54), 1.0108 allogeneic rabbit bone marrow-derived MSCs with osteogenic differentiation loaded on a
Conclusion: The allogeneic rabbit MSCs with and without osteogenic differentiation could promote spinal fusion. The differentiated/undifferentiated MSC groups had higher fusion mass BMD compared to the control group. References: 1. Pittenger MF, et al. Science 1999;284:143. Acknowledgement: The authors are grateful to note that this work had financial support from grants provided by the National Science Council of Taiwan (NSC 98-2314-B-182A-038-MY2 and NSC 100-2314-B-182A-011-MY2). Additional support was provided by Chang Gung Memorial Hospital, Taiwan (CMRPG890981). Disclosure of Interest: None Declared
P112 DIFFERENCE IN SPINE TBS BETWEEN MEN AND WOMEN: REAL OR TECHNICAL? W. D. Leslie1,*, L. Lix2, S. Morin3, S. Majumdar4, D. Hans5; 1Nuclear Medicine, 2 Department of Community Health Sciences, University of Manitoba, Winnipeg, 3 Internal Medicine, McGill University, Montreal, 4Division of General Internal Medicine, University of Alberta, Edmonton, Canada, 5Bone Disease Unit, Lausanne University Hospital, Lausanne, Switzerland Aims: Spine trabecular bone score (TBS) predicts osteoporotic and/or hip fractures in women and men independently of BMD and clinical risk factors. However, TBS software was optimized for women. Prodigy scanners (GE/Lunar) give average TBS values for men that are w13% lower than in women despite men having higher BMD and lower fracture risk. DXA image quality is degraded by soft tissue and also affects texture analysis. We hypothesized that soft tissue X-ray attenuation differences between men and women might account for the paradoxically lower spine TBS in men. We investigated whether sex differences in spine TBS on Prodigy scanners are technical or reflect real texture differences between men and women. Methods: Spine (L1-4) DXA exams (Prodigy, GE/Lunar) were identified in a database containing all clinical results for the Province of Manitoba, Canada. Lumbar spine TBS (TBS iNsightÒ) was derived from each spine DXA examination blinded to clinical parameters. From this database we extracted two matched groups of men and women: Group 1 (matched for age, BMI, scan year, DXA scanner) and Group 2 (matched for spine tissue thickness measured from DXA). Mean group differences were analyzed using t-tests and ANCOVA with FRAX clinical risk factors and prior osteoporosis treatment as covariates. Results: Group 1 contained 3511 matched pairs of men and women, and Group 2 contained 3417 matched pairs of men and women (mean age 68 years, BMI w27
Journal of Clinical Densitometry: Assessment & Management of Musculoskeletal Health
Volume 17, 2014