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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