Consensus definition of vertebral lytic defect size

Establish a standardized and reproducible definition of "defect size" for osteolytic lesions in human vertebral body studies that assess vertebral strength, deciding among definitions based on: (i) the ratio of a defect’s cross-sectional area to the vertebral body’s cross-sectional area at the middle transverse plane, (ii) the ratio at the largest lytic cross-section, (iii) the average ratio across multiple cross-sections, or (iv) a volumetric ratio using the whole vertebral body, to enable consistent comparisons of strength across studies.

Background

The paper provides open-access experimental data on human lumbar vertebral bodies with artificially created lytic defects under controlled boundary conditions, aiming to facilitate validation of subject-specific models for predicting vertebral failure.

In discussing how defect size impacts vertebral strength, the authors note that the literature lacks a unified definition: some studies use 2D cross-sectional area ratios (e.g., midplane, largest cross-section, or averages), while others use 3D volumetric ratios. This inconsistency hinders direct comparison and standardization. Despite their finding of no difference between 2D and 3D measures for end-to-end defects in their dataset, the broader issue of a standard definition remains unresolved across studies.