Ischemic collapse of the vertebral body: myth or reality?
Maldague, B.; Malghem, J.; Huaux, J.P.; Rombouts-Lindemans, C.; Noel, H.
Interior Design 62(1): 61-67
1979
ISSN/ISBN: 0020-5508 PMID: 10243921 Document Number: 7039
A peculiar type of progressive vertebral collapse was observed at the thoraco-lumbar junction of 22 patients (9 men and 13 women) aged 55 to 88 years (mean 68). Eleven of them were on chronic corticosteroid therapy. The radiological hallmark of these vertebral lesions is a gas-density cleft which appears in extension and disappears in flexion within a transverse separation of the vertebral body. Such an intravertebral vacuum cleft has not been found by the authors in vertebral collapses of tumoral, inflammatory or purely traumatic origin, and is thought to represent ischemic vertebral fracture. This is suggested by radiological, clinical and histological findings. It appears therefore that a bone ischemia may actually coexist with some vertebral fractures and may considerably alter their radiological aspect and evolution. This data could be helpful in the differential diagnosis of vertebral collapse in elderly patients: recognition of an intravertebral vacuum cleft should suggest bone ischemia and would avoid an unnecessary search for a more sinister origin of the associated vertebral collapse.
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