Damage accumulation in vertebral trabecular bone depends on loading mode and direction

Osteoporotic vertebral fractures constitute a major clinical problem in ageing societies. A third of all vertebral fractures is caused by falls, 15% by lifting heavy loads or traffic accidents and over 50% are not relatable to a traumatic event. In the latter case vertebrae show sinter processes which indicate the accumulation of damage and permanent deformation. Accumulated damage may not be visible on radiographs but increases the risk of fracture and could lead to vertebral collapse. Clear understanding of the accumulation of damage and residual strains and their dependence on loading mode and direction is important for understanding vertebral fractures. Altogether, 251 cylindrical samples (8×18-25. mm) were obtained from 50 male and 54 female fresh frozen human vertebrae (T1-L3) of 65 (21-94) years. Vertebrae were randomly assigned to three groups cranial-caudal, anterior-posterior and latero-lateral. Specimens were mechanically loaded in compression, tension or torsion in five load steps at a strain rate of 0.2%/s. Three conditioning cycles were driven per load step. Stress-strain curves were reconstructed from the force-displacement or from the moment-twist angle curves. Damage accumulated from 0 to 86% in compression, from 0 to 76% in tension and from 0 to 86% in torsion through the five load steps. Residual strains accumulated from 0 to -0.008. mm/mm in compression, 0 to 0.006. mm/mm in tension and 0 to 0.026. rad/rad in torsion. Significantly less damage (p