Most vertebral compression fractures are of benign origin. Less common causes include metastatic, hematologic or neoplastic disease. The spine represents the most frequent site of skeletal metastasis predominating in the thoracic and lumbar spine.

It is essential to differentiate benign from malignant vertebral collapse because their medical management and their outcome are substantially different.

Features supporting malignant collapse include involvement of dorsal elements, bulging of the dorsal vertebral wall, involvement of the posterior half of the vertebral body, associated soft tissue mass, contrast enhancement and multisegmental involvement of vertebrae.

The case was confirmed as metastatic disease on bone scan.