Comparison between continuous and discontinuous multiple vertebral compression fractures

• Published in: European spine journal Vol. 21; no. 9; pp. 1867 - 1872
• Main Authors: Kano, Shuji, Tanikawa, Hirotaka, Mogami, Yuji, Shibata, Shun-ichi, Takanashi, Seiji, Oji, Yoshihito, Aoki, Takashi, Oba, Hiroki, Ikegami, Shota, Takahashi, Jun
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-09-2012; Springer Nature B.V
• Subjects: Absorptiometry; Absorptiometry, Photon; Age; Aged; Bone Density; Bone mineral density; Compression; Female; Fractures; Fractures, Compression - etiology; Fractures, Compression - pathology; Humans; Injuries; Ionizing radiation; Lumbar Vertebrae - injuries; Magnetic resonance imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Original; Original Article; Osteoporosis; Pain; Sex; Spinal Fractures - etiology; Spinal Fractures - pathology; Spine; Surgical Orthopedics; Thoracic Vertebrae - injuries; Trauma; Vertebrae; Low energy; Osteoporosis; Vertebral compression fractures; Continuous type; High energy; Discontinuous type
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-012-2210-6

Background
The majority of multiple vertebral fractures (MVFs) occur under high-energy conditions; however, some cases occurring under minor-energy conditions exist. Fractures in successive vertebrae (continuous type) and in skipped vertebrae (discontinuous type) can exist.
Purpose
The objective of this study was to compare and evaluate the cause, level of injury, and relationship to osteoporosis between continuous and discontinuous MVFs.
Methods
We studied 77 subjects (173 vertebrae) who had presented with acute back pain between September 2007 and April 2010 and who received diagnoses of fresh MVFs through magnetic resonance imaging. Subjects with continuous and discontinuous fractures were evaluated based on age, sex, bone mineral density (BMD), level of affected vertebrae, and cause of injury.
Results
Subjects with discontinuous MVFs were significantly older and comprised more female patients. Mean BMD, measured by dual-emission X-ray absorptiometry, was 0.70 and 0.58 g/cm
3
for the continuous and discontinuous MVFs, respectively, demonstrating a significant difference. Of 34 patients with discontinuous MVFs, 32 (94%) exhibited vertebral fractures in the thoracolumbar junction. In subjects with continuous MVFs, the MVFs of 19 (44%) subjects were caused by high-energy trauma, whereas mild trauma and unknown cause were identified in 14 (41%) and 13 (38%) subjects with discontinuous MVFs, respectively.
Conclusions
Discontinuous MVFs generally caused by mild outer force, and often occurred at the thoracolumbar junction. Continuous MVFs, frequently, were caused by high-energy trauma.