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Posterior vertebral rim fractures

I Beggs1, J Addison

  • 1Department of Clinical Radiology, Royal Infirmary of Edinburgh, UK.

The British Journal of Radiology
|August 6, 1998
PubMed
Summary

Posterior vertebral endplate fractures cause low back pain and can mimic disc prolapse. Accurate imaging diagnosis is crucial, as standard surgical techniques for disc herniation are insufficient for these fractures.

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Area of Science:

  • Radiology
  • Orthopedics
  • Spinal Imaging

Background:

  • Posterior vertebral endplate fractures are a significant cause of low back pain in young individuals.
  • Clinical presentation can mimic acute disc prolapse with radiculopathy or neurogenic claudication in older patients due to spinal stenosis.
  • These fractures may also be discovered incidentally during imaging studies.

Purpose of the Study:

  • To review the key imaging findings of posterior vertebral endplate fractures.
  • To highlight the importance of accurate diagnosis for appropriate surgical management.
  • To differentiate endplate fractures from other spinal pathologies on various imaging modalities.

Main Methods:

  • Review of imaging findings from cases with posterior vertebral endplate fractures.
  • Analysis of plain radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) findings.
  • Correlation of imaging features with clinical presentations.

Main Results:

  • Plain radiographs are diagnostic in approximately 40% of cases.
  • CT effectively demonstrates the fracture fragment and vertebral defect in most instances.
  • MRI may sometimes overlook the fracture fragment, necessitating careful evaluation.
  • Accurate diagnosis is critical because surgical approaches for disc herniation are not suitable for endplate fractures.

Conclusions:

  • Accurate identification of posterior vertebral endplate fractures through imaging is essential.
  • Distinguishing endplate fractures from disc herniations guides appropriate treatment, as surgical techniques differ significantly.
  • Radiologists and clinicians should be aware of the varied imaging appearances and potential diagnostic challenges.

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