Effects of bone damage on creep behaviours of human vertebral trabeculae

A subgroup of patients suffering with vertebral fractures can develop progressive spinal deformities over time. The mechanism underlying such clinical observation, however, remains unknown. Previous studies suggested that creep deformation of the vertebral trabeculae may play a role. Using the acoustic emission (AE) technique, this study investigated effects of bone damage (modulus reduction) on creep behaviours of vertebral trabecular bone. Thirty-seven human vertebral trabeculae samples were randomly assigned into five groups (A to E). Bones underwent mechanical tests using similar experimental protocols but varied degree of bone damage was induced. Samples first underwent creep test (static compressive stress of 0.4 MPa) for 30 minutes, and then were loaded in compression to a specified strain level (0.4%, 1.0%, 1.5%, 2.5%, and 4% for group A to E, respectively) to induce different degrees of bone damage (0.4%, no damage control; 1.0%, yield strain; 1.5%, beyond yield strain, 2.5% and 4%, post-ultimate strains). Samples were creep loaded (0.4 MPa) again for 30 minutes. AE techniques were used to monitor bone damage. Bone damage increased significantly from group A to E (P<0.05), with more than 30% of modulus reduction in group D and E. Before compressive loading, creep deformation was not different among the five groups and AE hits in creep test were rare. After compressive loading, creep deformation was significantly greater in group D and E than those in other groups (P<0.05). The number of AE hits and other AE measurements during creep test were significantly greater in group D and E than in group A, B, and C (P<0.05 for all). Data suggested that with the increase of vertebral trabecular bone damage, substantial creep deformation may occur even when the vertebra was under physiological loads. The boosted creep deformation observed may be attributed to newly created trabecular microfractures. Findings provide a possible explanation as to why some vertebral fracture patients develop progressive spinal deformity over time.