Morphological Characteristics of Lumbar Vertebral Bodies and Regional Distribution Patterns of Bone Mineral Density: A CT Study

Objective To construct a comprehensive database of the macroscopic morphology and spatial distribution of bone mineral density (BMD) in lumbar vertebral bodies, elucidate the distribution patterns of lumbar structures, and provide precise reference data for spinal biomechanical modeling and clinical surgery. Methods One hundred healthy volunteers (50 males, 50 females; age range, 20-70 years) who underwent lumbar spine CT examination at the Department of Health Examination, Zhengzhou Orthopedic Hospital between September 2023 and September 2025 were prospectively enrolled. On CT images, seven morphological parameters (anterior, middle, and posterior vertebral body heights; superior and inferior endplate widths; anterior 1/3 and posterior 1/3 cortical thickness of the superior endplate) and CT values in 15 different regions (the vertebral body sagittal plane divided into upper, middle, and lower thirds; the horizontal plane divided into four quadrants) were measured for each vertebral body from L1 to L5. The variation patterns of each parameter were analyzed. Results ①Morphology: Superior and inferior endplate widths increased progressively from L1 to L5. The relationship between anterior and posterior vertebral body heights showed posterior height > anterior height at L1 and L2, approximately equal at L3, and anterior height > posterior height at L4 and L5. The cortical thickness of the anterior 1/3 of the superior endplate was generally smaller than that of the posterior 1/3, with a statistically significant difference (P < 0.05). ②CT values: Within each vertebral body, CT values showed an increasing trend from the upper 1/3 < middle 1/3 < lower 1/3. Comparison across segments roughly followed the pattern L1 > L2 > L5 > L3 > L4. Across all segments, the CT value in the anterosuperior region of the vertebral body (anterior quadrant of the upper 1/3) was the lowest. Conclusion The morphology of lumbar vertebral bodies exhibits regular changes from L1 to L5 to accommodate increasing axial loads and maintain physiological lordosis. There is significant heterogeneity in the distribution of BMD within the vertebral body, with the anterosuperior region identified as a "stress-weak zone," highly consistent with the predilection site for clinical compression fractures. The morphological and densitometric database established in this study can provide refined references for spinal surgery planning, implant design, and biomechanical research.