The intravertebral vacuum cleft: a sign of ischemic vertebral collapse

A gas-density cleft within a transverse separation of the vertebral body, appearing in extension and disappearing in flexion, was observed in 10 cases of vertebral collapse at the thoraco-lumbar junction. The patients were 55 to 83 years old (mean, 68) and 7 of them were on chronic corticosteroid therapy. Such an intravertebral cleft has not been found by the authors in vertebral collapse of tumoral, inflammatory, or traumatic origin and is thought to represent ischemic vertebral fracture. This sign could be helpful in the differential diagnosis of vertebral collapse in elderly patients.