| Objective To observe the morphological characteristics of bone tissue and the changes of bone metabolic markers in patients with osteoporotic vertebral compression fracture (OVCF). Methods One hundred and thirty-six OVCF patients were divided into 3 groups according to their bone mineral density (T values), group I -2.5 ≥ T value > -3.5; Group II -3.5 ≥ T value >-4.5; and group III T value ≤ -4.5. Bone metabolic markers were routinely examined in all cases. Bone biopsy specimens were obtained during vertebroplasty, which were defined according to bone histomorphometry criteria. Results Among all the cases, there were 66 cases in Group I (48.5%), 49 cases in Group II (36%), and 21 cases in Group III (15.4%). Bone histomorphometry results showed that BV/TV decreased gradually with the aggravation of osteoporosis. The decrease was the lowest (9.5±3.6%) in group III, and NBV/TV reached the peak (15.52± 2.15%) in group III. EBV/TV and FV/TV reached the peak value in group I (7.28±0.52%, 11.33±0.45%, respectively), and then they were replaced by trabecular bone. LBV/TV, as the later stage of mineralized bone tissue, reached the peak in group II (13.93±3.28%). Bone metabolic indexes showed that both osteogenic and osteoclast activities reached their peak values in group II. The peak values of OST, β-CTX, and PINP were 24.42±3.74 ng/mL, 0.90±0.17 ng/mL, and 76.10±6.33 ng/mL, respectively. Conclusion In severe cases of osteoporosis, a large amount of necrotic bone tissue and fibrous tissue are often present in the fractured vertebrae. The peak value of bone metabolic activity is at -3.5 ≥ T value >-4.5. |