Cadaveric Transilial Bone Biopsy: An Effective and Economic Approach to Study Bone Health
Authors: McCumber Travis , Byrd Jay , Snow Ethan , Bare Susan , Akhter Mohammed 
Published: May 2022

INTRODUCTIONA wide spectrum of diseases and disorders compromise bone mineral density (BMD) and bone microstructure, thus increasing the risk of bone damage and fracture. Clinically, bone imaging via dual energy X‐ray absorptiometry (DXA) and qualitative computed tomography (CT) allows for non‐destructive three‐dimensional structural analysis, but translational bone and mineral science often demands methodology that is beyond the capabilities of in vivo imaging. Human subject, transilial bone biopsy is a gold standard in translational bone and mineral science, allowing for quantitative micro‐CT and histomorphometry analyses. These analyses, however, require consent to elective surgical collection of a transilial bone biopsy, a taxing process that includes recruiting and retaining human research subjects. The purpose of this study was to review and demonstrate the use of cadaveric transilial bone analyses as an effective and economic approach to studying bone health.METHODSThe NIH National Library of Medicine electronic database was used to perform a systematic literature review according to the following cadaveric, BMD, and bone microstructure keywords: (human cadaver) AND (bone) AND (mineral density) AND (micro‐CT) OR (histomorphometry). Resulting citations were analyzed for effective and economic methodology for studying bone health. Additionally, quantitative micro‐CT and histomorphometry were performed on a cadaveric transilial bone biopsy to demonstrate protocol efficacies. 1) Superficial‐lateral gluteal muscles were reflected for open field access the gluteal surface of the iliac ala. A transilial biopsy containing both the external and internal iliac cortices was collected using an 8mm trephine at the standard human subject site, approximately 2 cm posterior and inferior to the anterior‐superior iliac spine. 2) Biopsies were subjected to compact cone‐beam tomography (micro‐CT‐40, Scanco Medical AG, Bassersdorf, Switzerland). Using 16um resolution, 3D isotropic images were collected with an integration of 250 milli‐seconds. 3) Biopsies were subjected to gradual dehydration in graded ethanol and acetone and subsequently embedded in methyl methacrylate. Serial sections were obtained with an otorizedmicrotome, stained, and mounted on glass slides.RESULTSThe systematic literature review yielded seventy‐eight citations demonstrating the utilization of human cadaveric bone to analyze bone mineral density (BMD) and bone microstructure. Twelve citations were excluded due to analysis of non‐human specimens, reporting of a case study, or manuscript access limitations. Protocol efficacies were confirmed with quantification of bone volume, connectivity density, structure model index, trabecular number, trabecular thickness, and trabecular separation via quantitative micro‐CT and histomorphometry analysis of cadaveric transilial biopsies.CONCLUSIONCadaveric transilial bone biopsy analysis via quantitative micro‐CT and histomorphometry provides an effective and economic approach to studying diseases and disorders that effect bone health.