Int J Med Sci 2004; 1(3):170-180. doi:10.7150/ijms.1.170


A review of anatomical and mechanical factors affecting vertebral body integrity

Andrew M Briggs1 2, Alison M Greig1, John D Wark2, Nicola L Fazzalari3, Kim L Bennell1

1. Centre for Health, Exercise and Sports Medicine, School of Physiotherapy, University of Melbourne, Australia.
2. Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Australia.
3. Institute of Medical and Veterinary Science, South Australia.


Background: The aetiology of osteoporotic vertebral fracture is multifactorial and may be conceptualised using a systems framework. Previous studies have established several correlates of vertebral fracture including reduced vertebral cross-sectional area, weakness in back extensor muscles, reduced bone mineral density, increasing age, worsening kyphosis and recent vertebral fracture. Alterations in these physical characteristics may influence biomechanical loads and neuromuscular control of the trunk and contribute to changes in subregional bone mineral density of the vertebral bodies.

Methods: This review discusses factors that have received less attention in the literature, which may contribute to the development of vertebral fracture. A literature review was conducted using electronic databases including Medline, Cinahl and ISI Web of Science to examine the potential contribution of trabecular architecture, subregional bone mineral density, vertebral geometry, muscle force, muscle strength, neuromuscular control and intervertebral disc integrity to the aetiology of osteoporotic vertebral fracture.

Interpretation: A better understanding of factors such as biomechanical loading and neuromuscular control of the trunk may help to explain the high incidence of subsequent vertebral fracture after sustaining an initial vertebral fracture. Consideration of these issues may be important in the development of prevention and management strategies.

Keywords: osteoporosis, vertebral fracture, bone density, spinal biomechanics, neuromuscular control

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See for full terms and conditions.
How to cite this article:
Briggs AM, Greig AM, Wark JD, Fazzalari NL, Bennell KL. A review of anatomical and mechanical factors affecting vertebral body integrity. Int J Med Sci 2004; 1(3):170-180. doi:10.7150/ijms.1.170. Available from