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Our working hypothesis is that the locations of vertebral fracture may be explained by the pattern of spine loading, such that during daily activities the mid\u2010thoracic and thoracolumbar regions experience preferentially higher mechanical loading compared to other spine regions. To test this hypothesis, we used a female musculoskeletal model of the full thoracolumbar spine and rib cage to estimate the variation in vertebral compressive loads and associated factor\u2010of\u2010risk (load\u2010to\u2010strength ratio) throughout the spine for 119 activities of daily living, while also parametrically varying spine curvature (high, average, low, and zero thoracic kyphosis models). We found that nearly all activities produced loading peaks in the thoracolumbar and lower lumbar regions of the spine, but that the highest factor\u2010of\u2010risk values generally occurred in the thoracolumbar region of the spine because these vertebrae had lower compressive strength than vertebrae in the lumbar spine. The peaks in compressive loading and factor\u2010of\u2010risk in the thoracolumbar region were accentuated by increasing thoracic kyphosis. Activation of the multifidus muscle fascicles selectively in the thoracolumbar region appeared to be the main contributor to the relatively high vertebral compressive loading in the thoracolumbar spine. In summary, by using advanced musculoskeletal modeling to estimate vertebral loading throughout the spine, this study provides a biomechanical mechanism for the higher incidence of fractures in thoracolumbar vertebrae compared to other spinal regions. \u00a9 2017 American Society for Bone and Mineral Research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jbmr.3113","type":"journal-article","created":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T22:32:59Z","timestamp":1488234779000},"page":"1282-1290","source":"Crossref","is-referenced-by-count":145,"title":["Spinal Loading Patterns From Biomechanical Modeling Explain the High Incidence of Vertebral Fractures in the Thoracolumbar Region"],"prefix":"10.1093","volume":"32","author":[{"given":"Alexander G","family":"Bruno","sequence":"first","affiliation":[{"name":"Harvard\u2010MIT Health Sciences and Technology Program Cambridge MA USA"},{"name":"Center for Advanced Orthopaedic Studies Beth Israel Deaconess Medical Center Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katelyn","family":"Burkhart","sequence":"additional","affiliation":[{"name":"Harvard\u2010MIT Health Sciences and Technology Program Cambridge MA USA"},{"name":"Center for Advanced Orthopaedic Studies Beth Israel Deaconess Medical Center Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Allaire","sequence":"additional","affiliation":[{"name":"Center for Advanced Orthopaedic Studies Beth Israel Deaconess Medical Center Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis E","family":"Anderson","sequence":"additional","affiliation":[{"name":"Center for Advanced Orthopaedic Studies Beth Israel Deaconess Medical Center Boston MA USA"},{"name":"Department of Orthopedic Surgery Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary L","family":"Bouxsein","sequence":"additional","affiliation":[{"name":"Harvard\u2010MIT Health Sciences and Technology Program Cambridge MA USA"},{"name":"Center for Advanced Orthopaedic Studies Beth Israel Deaconess Medical Center Boston MA USA"},{"name":"Department of Orthopedic Surgery Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,3,28]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Office of the Surgeon General (US). 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