"" Age-Related Changes of Lumbar Vertebral Body Morphometry

Research Article

Austin J Anat. 2014;1(3): 1014.

Age-Related Changes of Lumbar Vertebral Body Morphometry

Mavrych V1*, Bolgova O1, Ganguly P2 and Kashchenko S3

1Department of Anatomy, St. Matthew’s University, Cayman Islands

2Department of Anatomy, College of Medicine Alfaisal University, Saudi Arabia

3Department of Histology and Cell Biology, Lugansk State Medical University, Ukraine

*Corresponding author: Mavrych V, Department of Anatomy, St. Matthew’s University, School of Medicine, Save Haven, Leeward 3, Regatta Park, PO Box 32330, Grand Cayman, KY1-1209, Cayman Islands.

Received: July 18, 2014; Accepted: August 22, 2014; Published: August 28, 2014

Abstract

This study was designed to provide a large, accurate database of vertebral body size, focus–ing on age-related changes along the lumbar spine, and to look for size variations with relation to sex. All lumbar vertebrae (L1-L5) of 212 individuals (0-90 years) were dissected and analyzed by age and sex. A digital caliper was used to measure all vertebral body heights, lengths, and widths. This study showed that the vertebral body size was independent of sex but correlated with the individuals’ age. The most intensive growth of vertebral body sizes was found in children 1-7 year-old and the second peak of growth was observed in teenagers 13-16 year-old.

Anterior and posterior vertebral body heights were almost identical for all lumbar vertebrae in newborns and continuously increased through children, teenagers and adult age groups, then slightly decreased in senior persons due to osteopenia. The posterior vertebral body height was smaller than the anterior vertebral body height at L2 through L5 indicating posterior wedging with a peak at L3-L4 (except individuals of the 1st year of postnatal life). The superior vertebral body lengths constantly increased from L1 to L5 and inferior lengths - from L1 to L4, slightly decreased at L5. No significant difference was found between the superior and inferior vertebral body lengths of the same vertebra (P > 0.05). The superior vertebral body width typically was smaller than inferior widths of the same vertebra and superior width of adjacent inferior vertebra, resulting in a trapezoidal vertebral body shape in the lumbar spine.

As result of this research, a comprehensive database of vertebral body dimensions was generated from direct measurements of 1060 lumbar vertebrae. These results are invaluable in establishing an anthropometric model of the human lumbar spine, and provide useful data for spinal surgery and spinal implants design. In addition this information has important implications for workspace specifications for a robot-assisted surgery system.

Keywords: Vertebral body; Anatomical dimensions; Lumbar spine

Abbreviations

AVBH: Anterior Vertebral Body Height; PVBH: Posterior Vertebral Body Heights; SVBL: Superior Vertebral Body Length; IVBL: Inferior Vertebral Body Length; SVBW: Superior Vertebral Body Width; MVBW: Middle Vertebral Body Width; IVBW: Inferior Vertebral Body Width

Introduction

Existing databases of vertebral and inter vertebral dimensions are incomplete at present and limited either in accuracy, study population or parameters recorded. However, information on the precise dimensions of the lumbar vertebrae is essential for the spinal implants design, lumbar decompression surgery and workspace definition for robot-assisted surgery [1].

Previous studies have initiated the establishment of standard numeric values of vertebral body shape both in normal and pathological conditions [2-5]. The value of their data has depended on the number of samples and the accuracy of measurement. Many of the existing reports are based on a small sample size or isolated vertebrae of a small section of the spine. A comprehensive study of 12 specimens of human cadaveric lumbar vertebrae was published by Panjabi et al. however; the number of specimens was very limited as they were difficult to obtain [6]. Berry et al manually measured 30 skeletons, creating a database for implants but there was insufficient information to calculate lateral vertebral body sizes and not all pedicle dimensions were measured [7]. Fang et al. [8] reported an important study based upon CT scans of the lumbar spine obtained from Asian population, Aly and Amin [9] did research of lumbar spinal canal dimensions in Egyptians, but these are not necessarily applicable to Caucasians. The investigations of Zindrick et al. [10] and Chawla [11] were limited to the height, width, and transverse angles of vertebral pedicles. One large series was reported by Van Schaik et al. but they focused on the transverse process dimensions and structure only [12]. Gilad and Nissan measured the sagittal plane dimension of several anatomic structures of the vertebrae using lateral radiographs of 157 patients, and no data on L2 and L4 were provided [13]. Zhou et al published a large database of L3 - L5 vertebrae and L3/4 - L5/ S1 inter vertebral disks characteristics from 126 digitized CT scans, unfortunately the investigation was limited by a small section of the spine [14]. The anatomic dimensions of lumbar vertebrae from CT scans of 55 patients were reported by Wolf et al, their study was designed for a robotic surgery workspace creation [1]. In the comprehensive investigation of 240 adult human skeletons from the Cleveland Museum of Natural History by Masharawi et al. T1 - L5 vertebral body dimensions were obtained, but no age-related data were indicated [15].

The investigations of Kunkel et al. established some prediction equations for human thoracic and lumbar vertebral morphometry [16]. The morphological changes of the vertebrae associated with normal aging are still subject of debate, whereas this knowledge is important in detecting vertebral fractures and degenerative shape changes [17-22]. Some studies of human spine indicated a decrease in vertebral heights with advancing age and menopause [23,24]. Many studies indicated that the numerical mathematical modeling of the human spine for biomechanical studies requires the establishment of an accurate and large database on vertebral morphometry [25-27].

In this investigation, using a well-controlled sample size and measuring devices, the authors sought to establish morphometry standards for all lumbar vertebrae for all age groups and found age-related changes in vertebral body shape and sizes.

Materials and Methods

Study population

Direct measurements of 7420 lumbar vertebral body dimensions by digital caliper were obtained from 212 normal complete lumbar spines (107 male, 105 female) of individuals (0 - 90 years). All anatomic samples of lumbar spine had been collected in 2001-2006 from cadavers of Caucasian individuals living in Lugansk city and region in Pathology Department of Lugansk Regional Hospital under a license of Bioethical Commission of LSMU (file No:3, 10-NOV- 05), Ukraine. All specimens were originated from victims of trauma (without spine damage), poisonings, and asphyxia and sudden death form vascular disorders. The study material was distributed among 11 age groups: from newborns through senior people (Table 1).