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Peer-reviewedCC BY 4.0PLOS One

Investigation of age- and sex-related changes in cancellous bone density in the human spine using CT

  • Guido Schröder1
  • Aleksander J. Owczarek2
  • Estelle Akl3
  • Andreas Götz4
  • Steffi S. I. Falk5
  • Thomas Mittlmeier6
  • Laura Hiepe7
  • Andreas Büttner8
  • Michael Dau9
  • Daniel Wolter10
  • Julian Ramin Andresen11
  • Reimer Andresen12
2 more authors
  • Hans-Christof Schober
  • Änne Glass
12 affiliations
  1. 1Clinic for Orthopaedics and Trauma Surgery, Sana Hospital Bad Doberan, Academic Teaching Hospital of the University of Rostock, Hohenfelde, Germany
  2. 2Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
  3. 3Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology, Rostock University Medical Center, Rostock, Germany
  4. 4Institute for Biomedical Technology, Rostock University Medical Center, Warnemuende, Rostock, Germany
  5. 5Department of Trauma Surgery, Hand and Reconstructive Surgery, Rostock University Medical Center, Rostock, Germany
  6. 6Institute of Anatomy, Rostock University Medical Center, Rostock, Germany
  7. 7Institute of Legal Medicine, Rostock University Medical Center, Rostock, Germany
  8. 8Department of Oral & Maxillofacial Plastic Surgery, Rostock University Medical Center, Rostock, Germany
  9. 9Division of Trauma Surgery, Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel, Vienna, Austria
  10. 10Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
  11. 11OrthoCoast, Medical Office of Orthopedics and Osteology, Wolgast, Germany
  12. 12Institute for Biostatistics and Informatics in Medicine and Ageing Research, Rostock University Medical Center, Rostock, Germany
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Abstract

Studies of cancellous bone density across all spinal segments in relation to age and sex remain limited. This investigation aimed to quantify vertebral cancellous bone density in Hounsfield units (HU), to explore age‑ and sex‑related bone loss, and to compare HU measurements with bone mineral density (BMD) and bone volume fraction (BV/TV). Cancellous bone density was assessed in 71 spines (CT) covering vertebrae C3-L5 and the age range from 4 to 102 years. HU values were derived from mid‑vertebral regions, and in addition, BMD (L1-L3) and BV/TV measurements (Th12-L2, micro‑CT, 50 spines) in broad subsets of samples. The association between bone density and age was investigated by HU profiles along the spine in age groups and by regression approaches. HU values decreased with age (p < 0.001) and from cranial to caudal levels (p < 0.001), for both sexes (p < 0.001), with a marked reduction at the thoracolumbar junction beyond 60 years. Regression and cluster analyses revealed two phases of HU density loss with ongoing age, the second occurring in women (older than 64 years), later than in men (after 56 years) (p < 0.001). HU values were correlated with BMD (r = 0.86; 95% CI: 0.72–0.94) and with BV/TV (r = 0.51; 95% CI: 0.17–0.75). Density loss of bone with age is significant for BMD (for both sexes, p < 0.001) and for BV/TV (p ≤ 0.021), too, with an earlier reduction detected in the microarchitecture. These findings highlight the need for sex‑specific assessment and prevention strategies in osteoporosis research and clinical care.

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Cite

BibTeXRIS
BibTeX
@article{schroder2026investigation,
  title = {{Investigation of age- and sex-related changes in cancellous bone density in the human spine using CT}},
  author = {Guido Schröder and Aleksander J. Owczarek and Estelle Akl and Andreas Götz and Steffi S. I. Falk and Thomas Mittlmeier and Laura Hiepe and Andreas Büttner and Michael Dau and Daniel Wolter and Julian Ramin Andresen and Reimer Andresen and Hans-Christof Schober and Änne Glass},
  journal = {PLOS One},
  year = {2026},
  month = sep,
  doi = {10.1371/journal.pone.0358344},
  url = {https://doi.org/10.1371/journal.pone.0358344},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Investigation of age- and sex-related changes in cancellous bone density in the human spine using CT
AU  - Guido Schröder
AU  - Aleksander J. Owczarek
AU  - Estelle Akl
AU  - Andreas Götz
AU  - Steffi S. I. Falk
AU  - Thomas Mittlmeier
AU  - Laura Hiepe
AU  - Andreas Büttner
AU  - Michael Dau
AU  - Daniel Wolter
AU  - Julian Ramin Andresen
AU  - Reimer Andresen
AU  - Hans-Christof Schober
AU  - Änne Glass
PY  - 2026
DA  - 2026/09/28
JO  - PLOS One
DO  - 10.1371/journal.pone.0358344
UR  - https://doi.org/10.1371/journal.pone.0358344
AB  - Studies of cancellous bone density across all spinal segments in relation to age and sex remain limited. This investigation aimed to quantify vertebral cancellous bone density in Hounsfield units (HU), to explore age‑ and sex‑related bone loss, and to compare HU measurements with bone mineral density (BMD) and bone volume fraction (BV/TV). Cancellous bone density was assessed in 71 spines (CT) covering vertebrae C3-L5 and the age range from 4 to 102 years. HU values were derived from mid‑vertebral regions, and in addition, BMD (L1-L3) and BV/TV measurements (Th12-L2, micro‑CT, 50 spines) in broad subsets of samples. The association between bone density and age was investigated by HU profiles along the spine in age groups and by regression approaches. HU values decreased with age (p < 0.001) and from cranial to caudal levels (p < 0.001), for both sexes (p < 0.001), with a marked reduction at the thoracolumbar junction beyond 60 years. Regression and cluster analyses revealed two phases of HU density loss with ongoing age, the second occurring in women (older than 64 years), later than in men (after 56 years) (p < 0.001). HU values were correlated with BMD (r = 0.86; 95% CI: 0.72–0.94) and with BV/TV (r = 0.51; 95% CI: 0.17–0.75). Density loss of bone with age is significant for BMD (for both sexes, p < 0.001) and for BV/TV (p ≤ 0.021), too, with an earlier reduction detected in the microarchitecture. These findings highlight the need for sex‑specific assessment and prevention strategies in osteoporosis research and clinical care.
SN  - 1932-6203
ER  -