Spine Case 8 Diagnosis

Compression Fracture

Plain films are usually the initial modality. For patients with significant trauma or when other spine fractures are also considered, CT may be the initial test. CT can also better define fractures already diagnosed by plain films. If there is neurologic compromise, radicular symptoms, or hemorrhage, tumor, or infection is suspected, an MRI is indicated.

A crucial aspect of the evaluation is not to misclassify a burst fracture as a compression fracture. Compression fractures should cause anterior wedging but no loss of height of the posterior aspect of the vertebral body. If there is loss of height of the posterior portion of the vertebral body or retropulsed bone, the diagnosis is burst fracture. Burst fractures are unstable!