Gender differences in vertebral sizes in adults: biomechanical implications

Abstract

Purpose: To determine if vertebral bone densities or vertebral body sizes contribute to gender differences in vertebral bone mass in adults.

Materials and methods: Cancellous and cortical bone densities and dimensions of three lumbar vertebrae in 25 women and 18 men were measured with quantitative computed tomography (CT) and statistically analyzed.

Results: Neither cancellous nor cortical vertebral bone densities differed in healthy adults. Vertebral bodies in women had lower cross-sectional areas (8.22 cm2 +/- 1.09 [standard deviation] versus 10.98 cm2 +/- 1.25, P < .001) and volumes (22.42 cm3 +/- 2.40 versus 30.86 cm3 +/- 2.6, P < .001). These differences also were evident in men and women matched for age, weight, vertebral bone density, and vertebral body height. Overall cross-sectional areas of vertebral bodies are 25% smaller in women than men. Vertebral bone densities do not differ between sexes. Estimates of mechanical stress within vertebral bodies are 30%-40% higher in women than men for equivalent applied loads.

Conclusion: Smaller vertebral bodies in women confer biomechanical disadvantages that may contribute to more vertebral fractures in elderly women.