Spinal wedge fracture
Citation, DOI, disclosures and article data
Citation:
Knipe H, Gaillard F, Anan R, et al. Spinal wedge fracture. Reference article, Radiopaedia.org (Accessed on 26 Mar 2025) https://doi.org/10.53347/rID-35522
rID:
35522
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Disclosures:
At the time the article was created Henry Knipe had no recorded disclosures.
View Henry Knipe's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Frank Gaillard had no financial relationships to ineligible companies to disclose.
View Frank Gaillard's current disclosures
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Synonyms:
- Wedge fractures
- Vertebral body wedge fractures
- Wedge compression fractures
- Vertebral body wedge fracture
- Wedge compression fracture
Spinal wedge (compression) fractures are hyperflexion injuries to the vertebral body resulting from axial loading. Most commonly affecting the anterior aspect of the vertebral body, wedge fractures are considered a single-column (i.e. stable) fracture.
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Epidemiology
Spinal wedge compression fractures are the most common type (~50%) of thoracolumbar spine fractures 4.
Pathology
Typically, these fractures are insufficiency fractures secondary to osteoporosis, although some are pathological secondary to a focal bone lesion. A small proportion is due to trauma in patients with normal underlying bone 2.
Classification
Wedge fractures are recognised in the most commonly used classification systems:
wedge compression fracture (1 point) in thoracolumbar injury classification and severity score (TLICS)
Radiographic features
Radiographs, CT, and MRI may show cortical disruption with impaction of one endplate without the involvement of the posterior wall 6. This results in the characteristic "wedged" appearance 3,4.
Differential diagnosis
burst fracture: fracture of the anterior and posterior vertebral body (i.e. two-column injury) 4
split or pincer fracture: superior and inferior endplate fracture without posterior wall involvement 6
Practical points
care should be taken to assess for posterior ligamentous injury, indicative of potential instability
References
- 1. Parizel PM, van der Zijden T, Gaudino S et-al. Trauma of the spine and spinal cord: imaging strategies. Eur Spine J. 2010;19 Suppl 1 (S1): S8-17. doi:10.1007/s00586-009-1123-5 - Free text at pubmed - Pubmed citation
- 2. Old JL, Calvert M. Vertebral compression fractures in the elderly. Am Fam Physician. 2004;69 (1): 111-6. Pubmed citation
- 3. O'Brien WT. Top 3 Differentials in Radiology. Thieme. (2009) ISBN:1604062266. Read it at Google Books - Find it at Amazon
- 4. Pope TL. Harris & Harris' Radiology of Emergency Medicine. Lippincott Williams & Wilkins. (2012) ISBN:145110720X. Read it at Google Books - Find it at Amazon
- 5. Imhof H, Halpern B. Spinal Imaging (Direct Diagnosis in Radiology). TIS. ISBN:B005NA3E0K. Read it at Google Books - Find it at Amazon
- 6. Vaccaro A, Oner C, Kepler C et al. AOSpine Thoracolumbar Spine Injury Classification System: Fracture Description, Neurological Status, and Key Modifiers. Spine (Phila Pa 1976). 2013;38(23):2028-37. doi:10.1097/BRS.0b013e3182a8a381
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Articles:
- AO Spine classification of thoracolumbar injuries
- Pincer/split fracture
- Kyphosis
- Burst fracture
- Interspinous device
- Spinal fractures
- Vacuum phenomenon
- Thoracolumbar injury classification and severity score (TLICS)
- Cervical spine fractures
- Chance fracture
- Cervical spine radiograph (checklist)
- McAfee classification of thoracolumbar spinal fractures
- Anterior subluxation of the cervical spine
- Thoracolumbar spine fracture
- Musculoskeletal curriculum
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Cases:
- Burst fracture
- Bilateral locked facet joints
- Urothelial carcinoma with squamous differentiation
- Vertebral compression fracture
- Acute vertebral compression fracture
- Spinal compression fracture
- Spinal canal stenosis
- Vertebral body compression fracture - L2
- Vertebral body compression fracture - L1
- Vertebral body compression fracture - T12
- Vertebral body compression fracture
- Vertebral body compression fracture - L1
- Spondylolisthesis, spondylolysis and spondylosis, with osteoporosis and bilateral L5 sacralisation
- Vertebral burst fracture
- MitraClips
- Vertebral compression fracture
- Intravertebral cleft sign of vertebral compression fracture
- Vertebral compression fracture
- Spinal synovial cyst
- Spinal synovial cyst
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