[Pathological spine fractures]

Pathological vertebral body fractures are nontraumatic fractures caused by metabolic diseases, tumor infiltration, inflammatory processes or other pathological changes. They often represent the first manifestation of an undiagnosed underlying condition. The clinical presentation is variable, most commonly involving acute back pain and, in some cases, neurological deficits up to paraplegia. Tumor-related fractures are often progressive and resistant to conservative treatment.

Diagnostic evaluation is stepwise, beginning with X‑ray (basic assessment), followed by computed tomography (detailed fracture and bone analysis), and magnetic resonance imaging (differentiation between benign vs. malignant causes, tumor infiltration, and spinal cord compression).

Pathological vertebral body fractures should always be regarded as a potential first symptom of a serious underlying disease and must be promptly evaluated. This includes a thorough medical history, clinical examination, and appropriate stepwise imaging diagnostics. Therapeutic management depends on the underlying condition and the extent of the fracture, ranging from conservative treatment to surgical intervention.