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The dynamic mobility of vertebral compression fractures
Fergus McKiernan1, Ron Jensen, Tom Faciszewski
1Center for Bone Diseases, Marshfield Clinic, Marshfield, Wisconsin 54449, USA.
Summary
Many osteoporotic vertebral compression fractures (VCFs) exhibit dynamic mobility, impacting treatment. This previously unrecognized mobility can significantly affect vertebral height restoration interventions.
Area of Science:
- Orthopedics
- Radiology
- Gerontology
Background:
- Osteoporotic vertebral compression fractures (VCFs) are a common cause of pain and disability.
- The mobility of these fractures has not been well-characterized.
- Understanding fracture mobility is crucial for effective treatment.
Purpose of the Study:
- To document the existence of dynamic fracture mobility in osteoporotic VCFs.
- To estimate the frequency and define the nature of this mobility.
- To consider the implications for interventions like vertebroplasty.
Main Methods:
- Prospective radiographic analysis of 41 patients with 65 VCFs undergoing vertebroplasty.
- Comparison of preoperative standing and supine lateral radiographs to assess dynamic mobility.
- Manual digitization of radiographs for morphometric analysis.
Main Results:
- Dynamic fracture mobility was observed in 44% of patients (35% of VCFs).
- Mobile fractures showed significant postoperative height restoration (106% increase) and kyphosis reduction (40%).
- Intravertebral clefts were present in all mobile fractures and absent in fixed fractures.
Conclusions:
- Dynamic mobility is a previously unrecognized characteristic of many osteoporotic VCFs.
- This mobility can be substantial and clinically significant, particularly at the thoracolumbar junction.
- Vertebral height restoration interventions must account for dynamic fracture mobility.