Quantification of the structural role of the vertebral shell and trabecular centrum is essential to determine if the shell should be given equal consideration when predicting the fracture strength. The contribution of the cortical shell and endplate to the stiffness and strength of the vertebral body is not well understood and the literature remains controversial [1–5]. The uncertainty of the mechanistic support of the cortical shell and the role of its geometry is due in part to the difficulty in obtaining physical information about the shell[5]. A study on sheep vertebrae performed by Kasra and Grynpas [6] suggested a negative correlation between failure load and the tangent of the cortical shell curvature measured in the AP and lateral plane. Nevertheless, the structural role of the vertebral shell may be different in human vertebrae due to altered loading situations and different geometry. Another study by Edmonston et al. [7] implied a strong correlation between vertebral bone density and thoracic curvature. No study reported in the literature investigated the effect of the cortical shell concavity of human vertebral bodies on their mechanical properties.

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