Radiographic Diagnosis of Patients with Vertebral Compression Fractures

L5 Vertebra Plana: Imaging and Management of an Atypical Compression Fracture

“…Such atypical fractures necessitate assessment for pathologic features (e.g., crush morphology) and consideration of malignant or infectious etiologies 3 . Furthermore, lumbar levels have higher incidences of preexisting stenosis and disc herniation, often presenting with postfracture radiculopathy 3 . Although spinal canal or root involvement is uncommon in VCFs, magnetic resonance imaging should be considered in the presence of neurological symptoms, especially with a severe lumbar fracture.…”

“…Most VCFs are wedge or biconcave fractures resulting from axial loading and kyphotic flexion forces. 3 L5 compression fractures are unusual because the lower spine is relatively protected by the pelvis, surrounding tissue, and lordotic alignment. Thus, osteoporotic L5 vertebrae planae are exceedingly rare.…”

“…3 Furthermore, lumbar levels have higher incidences of preexisting stenosis and disc herniation, often presenting with postfracture radiculopathy. 3 Although spinal canal or root involvement is uncommon in VCFs, magnetic resonance imaging should be considered in the presence of neurological symptoms, especially with a severe lumbar fracture. This case exemplifies how even an extreme vertebral collapse can present atypically without pain at the corresponding level.…”

“…2 Magnetic resonance imaging is preferred for characterizing fracture morphology and acuity and when suspecting malignancy or neurological involvement. 3 Typical symptoms include focal pain and limited spinal mobility, leading to functional impairment. Even asymptomatic fractures are associated with increased mortality and risk of future fractures.…”

“…Most occur in the midthoracic or thoracolumbar spine, often diagnosed incidentally on chest/abdomen radiography 2 . Magnetic resonance imaging is preferred for characterizing fracture morphology and acuity and when suspecting malignancy or neurological involvement 3 . Typical symptoms include focal pain and limited spinal mobility, leading to functional impairment.…”