The empty vertebral body sign is referred to as a radiolucency on a vertebral body seen on the AP radiograph in patients with a flexion-distraction injury mechanism 1-3 caused by the absent superposition of the posterior spinal elements onto the vertebral body.
In other words, the sign results from the void left by an increased interspinous distance originally described with Chance fractures, where it has been described as a frequent finding 1. However, it is conceivable in any type of flexion-distraction injury as in posterior tension band injuries without osseous involvement of the spinous process.
Associated findings
- transversely oriented spinal fractures through pedicles, facet joints, posterior laminae costovertebral and/or transverse processes
- increased intercostal distance
- an increased interspinous distance on the lateral radiograph