Morphological characteristics of lumbar vertebral bodies and regional distribution patterns of bone mineral density:...

To establish a comprehensive database of the macroscopic morphology and spatial distribution of bone mineral density (BMD) in lumbar vertebral bodies, analyze morphological variation patterns of lumbar structures, and provide reference data for spinal biomechanical modeling and clinical surgery.

A total of 100 healthy volunteers (50 males, 50 females; age range, 20-70 years) who underwent lumbar spine CT evaluation at the Department of Health Examination, Zhengzhou Orthopedic Hospital between September 2023 and September 2025 were retrospectively enrolled in this study. On CT images, seven morphological parameters (anterior, middle, and posterior vertebral body heights; superior and inferior endplate widths; anterior one-third and posterior one-third cortical thickness of the superior endplate) and CT values in 15 different regions (the vertebral body sagittal plane divided into upper, middle, and lower thirds; the horizontal plane divided into anterior, posterior, left, and right quadrants) were measured for each vertebral body from L1 to L5.

① Morphology: Superior and inferior endplate widths increased progressively from L1 to L5. The relationship between anterior and posterior vertebral body heights showed posterior height > anterior height at L1 and L2, showed no statistically significant difference at L3, and anterior height > posterior height at L4 and L5. The cortical thickness of the anterior one-third of the superior endplate was significantly smaller according to the posterior one-third (P < 0.05). ② CT values: Within vertebral bodies, CT attenuation values showed a gradual increase from the upper one-third to the lower one-third regions. Comparison across segments roughly followed the pattern L1 > L2 > L5 > L3 > L4. Across all segments, the CT value in the anterosuperior region of the vertebral body (anterosuperior region) was the lowest.

The morphology of lumbar vertebral bodies demonstrates a consistent morphological trend from L1 to L5 which may be associated with increasing axial loads and contribute to physiological lordosis. There is significant heterogeneity in the distribution of BMD within the vertebral body, with the anterosuperior region identified as a "stress-weak zone, " highly consistent with the predilection site for clinical compression fractures. The morphological and densitometric database established in this study can provide reference data for spinal surgery planning, implant design, and biomechanical research.