Wedge compression fracture
History of trauma, back pain
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Wedge compression fracture of L3 vertebra (about 30% anterior height reduction), associated with diffuse marrow edema signal,
No retropulsed bone fragments.
Intact middle & posterior columns.
Multiple L1, L2, L4 & L5 vertebra hemangiomas
Reduced signal of L2/3 & L4/5 intervertebral discs.
L4/5 diffuse dorsal disc bulge with posterior central extrusion.
L2/3 mild dorsal annular disc bulge.
Wedged compression fractures
They are the most common type of lumbar fractures.
Isolated failure of the anterior column. Wedge-shaped vertebral body.
Mechanism of injury: hyperflexion and axial load.
These fracture are rarely associated with neural injury.
The main differential is Burst fracture (fracture of the anterior and middle columns with or without posterior column fracture, usually associated with neural injury)
The importance of differentiating compression from burst fractures lies in the higher frequency of neurological deficits associated with the latter.