Three-dimensional photographic study of cancellous bone in human fourth lumbar vertebral bodies

In an analysis of the 3D architecture of cancellous bone, two-dimensional techniques are of limited value. A simple technique employing stereophotographs of whole sections of lumbar vertebrate made possible a detailed description of the 3D structure of the normal fourth lumbar vertebral body and its changes with ageing and osteoporosis. Parallax measurements were used to calculate the real lengths of horizontal trabeculae. The bone presented a continuous spectrum of microstructure, from a honeycomb of tubes, to plates and braces and, finally, fragile rods. A distinct pattern was produced in osteoporotic samples by the removal of horizontal and selected vertical trabeculae followed by a thickening of the remaining vertical trabeculae in the peripheral regions. Very long, thin horizontal trabeculae were formed in all three zones (superior, middle and inferior) during this process. The observation of porotic architecture in intact specimens points to the inadequacy of the clinical criterion of the occurrence of a fracture in judging the osteoporotic state.