Comparison between continuous and discontinuous multiple vertebral compression fractures

摘要

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 comprisedmore female patients.MeanBMD, 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.