J Bone Metab.  2013 Nov;20(2):89-94. 10.11005/jbm.2013.20.2.89.

Radiographic Detection of Osteoporotic Vertebral Fracture without Collapse

• Kim YJ
• Chae SU
• Kim GD
• Park KH
• Lee YS
• Lee HY

• KMID: 2286299
• DOI: http://doi.org/10.11005/jbm.2013.20.2.89

Abstract

BACKGROUND
On retrospective basis, we investigated the detection of osteoporotic vertebral fractures (OVFs) without radiologic collapse using a modified Yoshida's classification, which was designed by the authors.
METHODS
We observed 82 cases in 76 patients with confirmed OVFs without collapse at the thoracolumbar junction. The following factors were measured: age, gender, body mass index (BMI, kg/m2), bone mineral density (BMD, mg/cm3), type of a modified Yoshida's classification. The correct diagnosis rate for the presence and location of OVFs and the correct diagnosis rate according to the morphological type by a modified Yoshida's classification of the OVFs were analyzed.
RESULTS
The mean BMI was 21.2; mean BMD, 44.1; and T-score, -4.4. As for the four subtypes of anterior cortical morphological change, there were 14 cases of the protruding type, 12 cases of the indented type, 5 cases of the disrupted type and 8 cases of the prow type. As for the three subtypes of endplate depression, there were 20 cases of upper endplate depression, 12 cases of lower endplate depression and 11 cases of endplate slippage type. According to the examiners, there was a significant difference between being informed before and after the modified Yoshida's classification. For the relationship of examiners and the type of fracture, there was a significant difference between being informed before and after the modified Yoshida's classification, particularly in the protruding type and the upper plate type.
CONCLUSIONS
A modified Yoshida's classification can be helpful for the diagnosis of OVFs without radiologic collapse in a simple radiograph.

Keyword

Anterior cortical morphology; Osteoporotic vertebral fractures; Radiographic diagnosis; Spine endplate

MeSH Terms

Body Mass Index
Bone Density
Classification
Depression
Diagnosis
Humans
Retrospective Studies

Figure

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  Fig. 1 A modified Yoshida classified into two types and seven subtypes. Anterior cortical morphological change types: Protrusion type, the anterior bony cortex disrupted protrudes anteriorly; indented type, the anterior bony cortex disrupted indents posteriorly; disrupted type, the anterior bony cortex disrupted with no displacement; prow type, the anterior bony cortex disrupted mixed of anterior and posterior. Endplate compression types: upper endplate depression type, the center of the upper endplate disrupted and depression; lower endplate depression type, the center of the lower endplate disrupted and depression; endplate slippage type, the anterior edge of the endplate disrupted anteriorly.

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  Fig. 2 An 87-year-old woman with occult osteoporotic vertebral fractures of L1 (A), confirmed by magnetic resonance imaging (B). L1 has a change of anterior cortex morphology (protruding type of modified Yoshida's classification) (arrow).

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  Fig. 3 A 92-year-old woman with occult osteoporotic vertebral fractures of L1 (A), confirmed by MRI (B). L1 has a change of endplate morphology (upper endplate slippage type of modified Yoshida's classification) (arrow).

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