J Korean Soc Spine Surg.  2015 Sep;22(3):104-108. 10.4184/jkss.2015.22.3.104.

Diagnosis of Osteoporotic Spinal Fractures

• Kim YH
• Kim SI
• Han SY

• KMID: 2068928
• DOI: http://doi.org/10.4184/jkss.2015.22.3.104

Abstract

STUDY DESIGN: Literature review.
OBJECTIVES
To present updated information on the diagnosis of osteoporotic spinal fractures (OSFs). SUMMARY OF LITERATURE REVIEW: Conventional modalities including simple radiographs, bone mineral density (BMD) tests, and bone scans are sufficient for diagnosis of OSFs. However, other clinical and radiographic clues should be considered for prediction of the prognosis and differential diagnosis.
MATERIALS AND METHODS
Review of the relevant literature.
RESULTS
Clinical clues including morphometric changes in the vertebral body are sufficient for diagnosis of OSFs. BMD testing is helpful for diagnosis of osteoporosis. However, simple radiographs and BMD tests do not present sufficient information on the prognosis of OSFs. The location of the involved segments, morphological characteristics, and other co-morbidities should be taken into consideration in the initial management of OSFs. Moreover, pathologic conditions leading to spinal fractures should be taken into account in some clinical situations.
CONCLUSIONS
With increasing reports of complicated OSFs or other pathologic fractures, other diagnostic modalities and clinical factors should be considered in predicting the prognosis of OSFs and differentiating OSFs from other pathologic conditions.

Keyword

Osteoporosis; Spinal fractures; Diagnosis; Complication

MeSH Terms

Bone Density
Diagnosis*
Diagnosis, Differential
Fractures, Spontaneous
Osteoporosis
Prognosis
Spinal Fractures*

Figure

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  Fig. 1. Radiographic characteristics for differential diagnosis of osteoporotic spinal fractures with pathologic fractures. A 52-year-old man presenting multiple compression fractures. T2 weighted (A), T1 weighted (B) and T2 fat suppression (C) images show multiple spinal fractures with posterior bulging of the vertebral body, involvement of the posterior column, and decreased signal intensity of the marrow compared to the intervertebral disc (*) in the T1 weighted image.

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  Fig. 2. A 76 year old woman presented acute osteoporotic spinal fracture with dynamic instability. Standing (A) and supine (B) radiographs show the intravertebral cleft at the index vertebra (*) with dynamic instability.

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