The Vertebral Body Compression Fracture Radiology Guide
The Vertebral Body Compression Fracture Radiology Guide A vertebral body compression fracture is a common spinal injury often caused by osteoporosis, trauma, or other underlying conditions weakening the vertebral bones. Detecting and diagnosing these fractures accurately is vital for appropriate treatment planning and management. Radiology plays a crucial role in identifying these injuries, with various imaging modalities providing detailed insights into the fracture’s characteristics and severity.
Typically, the initial imaging study for suspected vertebral compression fractures is plain radiography. Conventional X-rays can reveal the classic signs of a compression fracture, such as a wedge-shaped vertebral body, loss of height, or increased kyphosis. However, X-rays may sometimes be insufficient, especially in early or subtle cases, necessitating more advanced imaging techniques. The Vertebral Body Compression Fracture Radiology Guide
Computed tomography (CT) scans offer superior spatial resolution and detailed cross-sectional images of the vertebrae. CT is particularly valuable when assessing the fracture’s morphology, detecting cortical disruptions, or evaluating complex fracture patterns. Its ability to visualize bony structures precisely makes it an essential tool in preoperative planning or when surgical intervention is considered. The Vertebral Body Compression Fracture Radiology Guide
The Vertebral Body Compression Fracture Radiology Guide Magnetic resonance imaging (MRI) is arguably the most informative modality for vertebral compression fractures, especially in differentiating between acute and chronic injuries. MRI can detect bone marrow edema, which appears as high signal intensity on T2-weighted and STIR sequences, indicating an acute or recent fracture. Conversely, the absence of edema suggests a chronic or healed fracture. MRI also aids in identifying associated soft tissue injuries, epidural hematomas, or neural element compression, which are critical considerations in symptomatic cases.
In addition to these imaging techniques, certain radiological signs are characteristic of compression fractures. The anterior wedge deformity, where the front part of the vertebral body collapses more than the posterior part, is typical. The degree of height loss can be quantified to assess severity, often expressed as a percentage of vertebral height reduction. More severe fractures may show retropulsion of bony fragments into the spinal canal, increasing the risk of neurological compromise.
Understanding the fracture classification is essential in guiding treatment. The Genant classification, for instance, categorizes vertebral fractures based on the degree of height loss: Grade 1 (20-25% height reduction), Grade 2 (25-40%), and Grade 3 (>40%). Radiological assessment also involves evaluating the fracture’s stability, presence of posterior wall involvement, and any signs of underlying pathology such as malignancy or infection. The Vertebral Body Compression Fracture Radiology Guide
The Vertebral Body Compression Fracture Radiology Guide In clinical practice, radiologists must distinguish incidental fractures from those associated with malignancy or infection, which may have different imaging features. Features suggestive of pathological fractures include irregular fracture margins, destruction of vertebral body cortex, and involvement of multiple levels.
In summary, radiology provides vital insights into vertebral body compression fractures through a combination of plain X-rays, CT, and MRI. Each modality has unique strengths, and their combined use ensures accurate diagnosis, assessment of fracture severity, and guidance for optimal management.
