It will also show bone alignment, disc degeneration and bony spurs which may irritate nerve roots. X-ray: An x-ray produces a picture of a part of the body and can show the structure of the vertebrae and the outline of the joints.While a diagnosis can usually be made through history and a physical examination, plain x-rays, computed tomography (CT) or magnetic resonance imaging (MRI) can help in confirming diagnosis, predicting prognosis and determining the best treatment option for the patient. The cancer may cause destruction of part of the vertebra, weakening the bone until it collapses. The bones of the spine are a common place for many types of cancers to spread. Metastatic tumors should be considered as the cause in patients younger than 55 with no history of trauma or only minimal trauma. People with healthy spines most commonly suffer a VCF through severe trauma, such as a car accident, sports injury or a hard fall. Occasionally, a VCF can be present with either minor symptoms or no symptoms, but the risk still exists for additional VCFs to occur. People who have had one osteoporotic VCF are at five times the risk of sustaining a second VCF. Although far more common in women, VCFs are also a major health concern for older men. The occurrence of this condition steadily increases as people age, with an estimated 40% of women age 80 and older affected. VCFs affect an estimated 25% of all postmenopausal women in the U.S. VCFs are the most common fracture in patients with osteoporosis, affecting about 750,000 people annually. In people with moderate osteoporosis, it usually takes increased force or trauma, such as falling down or attempting to lift a heavy object to cause a VCF. doi:10.1097/BRS.In people with severe osteoporosis (weak, brittle bones), a VCF may be caused by simple daily activities, such as stepping out of the shower, sneezing forcefully or lifting a light object. AOSpine Thoracolumbar Spine Injury Classification System: Fracture Description, Neurological Status, and Key Modifiers. Discrimination of Metastatic from Acute Osteoporotic Compression Spinal Fractures with MR Imaging1. Spinal compression fractures in osteoporotic women: patterns and relationship to hyperkyphosis. De Smet AA, Robinson RG, Johnson BE et-al. Osteoporotic vertebral compression fractures and vertebral augmentation. The treatment of symptomatic osteoporotic spinal compression fractures. Kyphoplasty: balloon-assisted variant of vertebroplasty Medications: bisphosphonates for osteoporosis Retropulsion (not posterior bulging) of the posterosuperior cortex of the vertebral body Low signal intensity band on T1WI and T2WI indicating a fracture line Preserved normal fatty bone marrow T1WI signal The following features favor the diagnosis of a benign compression fracture: Osteoporotic vs pathologicalĭiscriminating between acute osteoporotic fracture and pathological fracture is sometimes challenging. In uncertain cases, MRI signs of edema (acute) and the presence of radiotracer uptake on bone scintigraphy (acute) help decide the age of the fracture. On conventional imaging, acute fracture signs include cortical breaking or impaction of trabeculae in the absence of these signs fractures are chronic. Acute vs chronicĬhronicity of the fracture indicates its temporal relationship with symptoms and hence is an important determination. When in doubt, it is recommended that additional views or studies be advised for confirmation. The vertebral fracture should be diagnosed when there is a loss of height in the anterior, middle, or posterior dimension of the vertebral body that exceeds 20%. This defines the role of the radiologist in making an accurate diagnosis. Vertebral fractures require treatment when they are symptomatic, i.e. with pain and loss of mobility. Osteoporotic spine fractures can be graded with the Genant classification of vertebral fractures based on vertebral height loss as: See: AO spine classification of thoracolumbar injuries. Pincer or split fracture: involvement of both endplates but not the posterior wallīurst fracture: involvement of one endplate (incomplete) or both endplates (complete) and the posterior wall Wedge compression fracture: involvement of one endplate but not the posterior wall PathologyĬompression fractures can result from osteoporosis, trauma or represent a pathological fracture secondary to another process (e.g. Vertebral fractures present with pain and loss of mobility. ![]() However, they are largely unreported and are probably more common radiographically (present up to 14% of women older than 60 years in one study 1). person-years after 85 years of age in the United States.
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