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Wedge compression fracture

Case contributed by Dalia Ibrahim
Diagnosis certain

Presentation

History of trauma, back pain.

Patient Data

Age: 45 years
Gender: Male
mri

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 vertebral 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.

Case Discussion

Wedged compression fractures:

  • the most common type of lumbar fractures

  • isolated failure of the anterior column

  • wedge-shaped vertebral body

  • mechanism of injury: hyperflexion and axial load

  • 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.

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