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Compression Fracture
Kevin R. Moore, MD; Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Wedge compression
            • Definitions

              • Vertebral body fracture compressing anterior cortex, sparing middle/posterior columns

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Chen Z et al: Risk factors of secondary vertebral compression fracture after percutaneous vertebroplasty or kyphoplasty: a retrospective study of 650 patients. Med Sci Monit. 25:9255-61, 2019
                                        2. Cheng J et al: Percutaneous vertebroplasty vs balloon kyphoplasty in the treatment of newly onset osteoporotic vertebral compression fractures: a retrospective cohort study. Medicine (Baltimore). 98(10):e14793, 2019
                                        3. Mattie R et al: Comparing percutaneous vertebroplasty and conservative therapy for treating osteoporotic compression fractures in the thoracic and lumbar spine: a systematic review and meta-analysis. J Bone Joint Surg Am. 98(12):1041-51, 2016
                                        4. Kroon F et al: Two-year results of a randomized placebo-controlled trial of vertebroplasty for acute osteoporotic vertebral fractures. J Bone Miner Res. 29(6):1346-55, 2014
                                        5. Rho YJ et al: Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty. Eur Spine J. 21(5):905-11, 2012
                                        6. Esses SI et al: The treatment of symptomatic osteoporotic spinal compression fractures. J Am Acad Orthop Surg. 19(3):176-82, 2011
                                        7. Klazen CA et al: Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet. 376(9746):1085-92, 2010
                                        8. Capeci CM et al: Bilateral low-energy simultaneous or sequential femoral fractures in patients on long-term alendronate therapy. J Bone Joint Surg Am. 91(11):2556-61, 2009
                                        9. Kallmes DF et al: A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med. 361(6):569-79, 2009
                                        10. Folman Y et al: Late outcome of nonoperative management of thoracolumbar vertebral wedge fractures. J Orthop Trauma. 17(3):190-2, 2003
                                        11. Haba H et al: Diagnostic accuracy of magnetic resonance imaging for detecting posterior ligamentous complex injury associated with thoracic and lumbar fractures. J Neurosurg. 99(1 Suppl):20-6, 2003
                                        12. Hiwatashi A et al: Increase in vertebral body height after vertebroplasty. AJNR Am J Neuroradiol. 24(2):185-9, 2003
                                        13. Hsu JM et al: Thoracolumbar fracture in blunt trauma patients: guidelines for diagnosis and imaging. Injury. 34(6):426-33, 2003
                                        14. Naves M et al: The effect of vertebral fracture as a risk factor for osteoporotic fracture and mortality in a Spanish population. Osteoporos Int. 14(6):520-4, 2003
                                        15. Phillips FM: Minimally invasive treatments of osteoporotic vertebral compression fractures. Spine. 28(15):S45-53, 2003
                                        16. Sapkas GS et al: Thoracic spinal injuries: operative treatments and neurologic outcomes. Am J Orthop. 32(2):85-8, 2003
                                        17. Sheridan R et al: Reformatted visceral protocol helical computed tomographic scanning allows conventional radiographs of the thoracic and lumbar spine to be eliminated in the evaluation of blunt trauma patients. J Trauma. 55(4):665-9, 2003
                                        18. Wintermark M et al: Thoracolumbar spine fractures in patients who have sustained severe trauma: depiction with multi-detector row CT. Radiology. 227(3):681-9, 2003
                                        19. Baur A et al: Acute osteoporotic and neoplastic vertebral compression fractures: fluid sign at MR imaging. Radiology. 225(3):730-5, 2002
                                        20. Lane JM et al: Minimally invasive options for the treatment of osteoporotic vertebral compression fractures. Orthop Clin North Am. 33(2):431-8, viii, 2002
                                        21. O'Connor PA et al: Spinal cord injury following osteoporotic vertebral fracture: case report. Spine. 27(18):E413-5, 2002
                                        22. Parisini P et al: Treatment of spinal fractures in children and adolescents: long-term results in 44 patients. Spine. 27(18):1989-94, 2002
                                        23. Robertson A et al: Spinal injury patterns resulting from car and motorcycle accidents. Spine. 27(24):2825-30, 2002
                                        24. Wittenberg RH et al: Noncontiguous unstable spine fractures. Spine. 27(3):254-7, 2002
                                        25. Zhou XJ et al: Characterization of benign and metastatic vertebral compression fractures with quantitative diffusion MR imaging. AJNR Am J Neuroradiol. 23(1):165-70, 2002
                                        26. Holmes JF et al: Epidemiology of thoracolumbar spine injury in blunt trauma. Acad Emerg Med. 8(9):866-72, 2001
                                        27. Lindsay R et al: Risk of new vertebral fracture in the year following a fracture. JAMA. 285(3):320-3, 2001
                                        28. Vaccaro AR et al: Post-traumatic spinal deformity. Spine. 26(24 Suppl):S111-8, 2001
                                        29. Kerttula LI et al: Post-traumatic findings of the spine after earlier vertebral fracture in young patients: clinical and MRI study. Spine. 25(9):1104-8, 2000
                                        30. van Beek EJ et al: Upper thoracic spinal fractures in trauma patients - a diagnostic pitfall. Injury. 31(4):219-23, 2000
                                        31. Rechtine GR 2nd et al: Treatment of thoracolumbar trauma: comparison of complications of operative versus nonoperative treatment. J Spinal Disord. 12(5):406-9, 1999
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Wedge compression
                                                  • Definitions

                                                    • Vertebral body fracture compressing anterior cortex, sparing middle/posterior columns

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Nuclear Medicine Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Chen Z et al: Risk factors of secondary vertebral compression fracture after percutaneous vertebroplasty or kyphoplasty: a retrospective study of 650 patients. Med Sci Monit. 25:9255-61, 2019
                                                                              2. Cheng J et al: Percutaneous vertebroplasty vs balloon kyphoplasty in the treatment of newly onset osteoporotic vertebral compression fractures: a retrospective cohort study. Medicine (Baltimore). 98(10):e14793, 2019
                                                                              3. Mattie R et al: Comparing percutaneous vertebroplasty and conservative therapy for treating osteoporotic compression fractures in the thoracic and lumbar spine: a systematic review and meta-analysis. J Bone Joint Surg Am. 98(12):1041-51, 2016
                                                                              4. Kroon F et al: Two-year results of a randomized placebo-controlled trial of vertebroplasty for acute osteoporotic vertebral fractures. J Bone Miner Res. 29(6):1346-55, 2014
                                                                              5. Rho YJ et al: Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty. Eur Spine J. 21(5):905-11, 2012
                                                                              6. Esses SI et al: The treatment of symptomatic osteoporotic spinal compression fractures. J Am Acad Orthop Surg. 19(3):176-82, 2011
                                                                              7. Klazen CA et al: Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet. 376(9746):1085-92, 2010
                                                                              8. Capeci CM et al: Bilateral low-energy simultaneous or sequential femoral fractures in patients on long-term alendronate therapy. J Bone Joint Surg Am. 91(11):2556-61, 2009
                                                                              9. Kallmes DF et al: A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med. 361(6):569-79, 2009
                                                                              10. Folman Y et al: Late outcome of nonoperative management of thoracolumbar vertebral wedge fractures. J Orthop Trauma. 17(3):190-2, 2003
                                                                              11. Haba H et al: Diagnostic accuracy of magnetic resonance imaging for detecting posterior ligamentous complex injury associated with thoracic and lumbar fractures. J Neurosurg. 99(1 Suppl):20-6, 2003
                                                                              12. Hiwatashi A et al: Increase in vertebral body height after vertebroplasty. AJNR Am J Neuroradiol. 24(2):185-9, 2003
                                                                              13. Hsu JM et al: Thoracolumbar fracture in blunt trauma patients: guidelines for diagnosis and imaging. Injury. 34(6):426-33, 2003
                                                                              14. Naves M et al: The effect of vertebral fracture as a risk factor for osteoporotic fracture and mortality in a Spanish population. Osteoporos Int. 14(6):520-4, 2003
                                                                              15. Phillips FM: Minimally invasive treatments of osteoporotic vertebral compression fractures. Spine. 28(15):S45-53, 2003
                                                                              16. Sapkas GS et al: Thoracic spinal injuries: operative treatments and neurologic outcomes. Am J Orthop. 32(2):85-8, 2003
                                                                              17. Sheridan R et al: Reformatted visceral protocol helical computed tomographic scanning allows conventional radiographs of the thoracic and lumbar spine to be eliminated in the evaluation of blunt trauma patients. J Trauma. 55(4):665-9, 2003
                                                                              18. Wintermark M et al: Thoracolumbar spine fractures in patients who have sustained severe trauma: depiction with multi-detector row CT. Radiology. 227(3):681-9, 2003
                                                                              19. Baur A et al: Acute osteoporotic and neoplastic vertebral compression fractures: fluid sign at MR imaging. Radiology. 225(3):730-5, 2002
                                                                              20. Lane JM et al: Minimally invasive options for the treatment of osteoporotic vertebral compression fractures. Orthop Clin North Am. 33(2):431-8, viii, 2002
                                                                              21. O'Connor PA et al: Spinal cord injury following osteoporotic vertebral fracture: case report. Spine. 27(18):E413-5, 2002
                                                                              22. Parisini P et al: Treatment of spinal fractures in children and adolescents: long-term results in 44 patients. Spine. 27(18):1989-94, 2002
                                                                              23. Robertson A et al: Spinal injury patterns resulting from car and motorcycle accidents. Spine. 27(24):2825-30, 2002
                                                                              24. Wittenberg RH et al: Noncontiguous unstable spine fractures. Spine. 27(3):254-7, 2002
                                                                              25. Zhou XJ et al: Characterization of benign and metastatic vertebral compression fractures with quantitative diffusion MR imaging. AJNR Am J Neuroradiol. 23(1):165-70, 2002
                                                                              26. Holmes JF et al: Epidemiology of thoracolumbar spine injury in blunt trauma. Acad Emerg Med. 8(9):866-72, 2001
                                                                              27. Lindsay R et al: Risk of new vertebral fracture in the year following a fracture. JAMA. 285(3):320-3, 2001
                                                                              28. Vaccaro AR et al: Post-traumatic spinal deformity. Spine. 26(24 Suppl):S111-8, 2001
                                                                              29. Kerttula LI et al: Post-traumatic findings of the spine after earlier vertebral fracture in young patients: clinical and MRI study. Spine. 25(9):1104-8, 2000
                                                                              30. van Beek EJ et al: Upper thoracic spinal fractures in trauma patients - a diagnostic pitfall. Injury. 31(4):219-23, 2000
                                                                              31. Rechtine GR 2nd et al: Treatment of thoracolumbar trauma: comparison of complications of operative versus nonoperative treatment. J Spinal Disord. 12(5):406-9, 1999