Spinal wedge fracture
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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.
Less commonly wedge fractures refer to a subtype of tibial plateau fractures.
Most common type (~50%) of thoracolumbar spine fractures 4.
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.
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.
- 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
- care should be taken to assess for posterior ligamentous injury, indicative of potential instability
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- 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