![]() A wedge compression fracture is generally a mechanically stable fracture pattern. This process results in a wedge-shaped vertebra. The term "wedge fracture" is used because the fracture usually occurs in the front of the vertebra, collapsing the bone in the front of the spine and leaving the back of the same bone unchanged. Types of FractureĪ spinal fracture due to osteoporosis (weak bones) is commonly referred to as a compression fracture, but can also be called a vertebral fracture, osteoporotic fracture, or wedge fracture. They often occur in the upper lumbar segments as well, such as L1. They rarely occur above the T7 level of the spine. These compression fractures can occur in vertebrae anywhere in the spine, but they tend to occur most commonly in the upper back (thoracic spine), particularly in the lower vertebrae of that section of the spine (e.g. To watch a video about neck strains, click here: A compression fracture is usually defined as a vertebral bone in the spine that has decreased at least 15 to 20% in height due to fracture. doi:10.1097/BRS.The type of fracture in the spine that is typically caused by osteoporosis is generally referred to as a compression fracture. 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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