Diagnosis of Osteoporotic Spinal Fractures

Young-Hoon Kim; Sang-Il Kim; Sang-Yup Han

doi:10.4184/jkss.2015.22.3.104

Journal List > J Korean Soc Spine Surg > v.22(3) > 1076053

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Kim, Kim, and Han: Diagnosis of Osteoporotic Spinal Fractures

Review Article

Journal of Korean Spine Surg 2015;22(3):104-108.

Published online: 21 September 2015

DOI: https://doi.org/10.4184/jkss.2015.22.3.104

Diagnosis of Osteoporotic Spinal Fractures

Young-Hoon Kim, M.D., Ph.D., Sang-Il Kim, M.D., Sang-Yup Han, M.D.

Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Corresponding author: Young-Hoon Kim, M.D., Ph.D. Department of Orthopedic Surgery, Seoul St. Mary's Hospital, School of Medicine, The Catholic University of Korea, Seoul, Korea 222 Banpodae-ro, Seocho-Gu, Seoul, 137-701, Korea TEL: +82-2-2258-6118, FAX: +82-2-535-9834 E-mail: boscoa@catholic.ac.kr

Received 18 August 2015 Revised 18 August 2015 Accepted 2 September 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Osteoporosis, Spinal fractures, Diagnosis, Complication

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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.

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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