My Orthopaedic Surgeon

Table showing types of spine fracture, the columns involved and the mechanisms

fall from a height, landing on one's feet, is a typical cause of this fracture;
- burst frx involve only compressive failure of the vertebral body both anteriorly & posteriorly, w/ failure of both anterior & middle columns;
- axial loading applied to intravertebral disc results in increased nuclear pressure and hoop stresses in the annulus;
- this results in a high shear stress on the vertebral end plate at inner border of the annulus, away from the center of the disc;
- a large central posterior-superior fragment occurs as a result of these forces;

From American Journal of Roentgenology
Diagnosis of Osteoporotic Vertebral Fractures: Importance of Recognition and Description by Radiologists Posted 10/06/2004 (full text) Leon Lenchik; Lee F. Rogers; Pierre D. Delmas; Harry K. Genant

Illustrated Lecture

Most of patients experiencing an osteoporotic vertebral compression fracture remain asymptomatic or minimally symptomatic; however, a large number of these patients do experience significant pain resulting in decreased quality of life and disability. Conventional medical treatment for these patients includes pain medication, activity limitation, physical therapy, and possibly, bracing. Vertebroplasty and kyphoplasty are two minimally invasive spine procedures that have emerged as viable treatments for those patients who do not respond to more conservative measures. Surgery for this population of patients is not well tolerated and is typically performed only as a last resort in severe cases.
Synonyms and related keywords:>/b> osteoporosis, back pain, osteoporotic vertebral compression fractures, diminished bone density, vertebroplasty, kyphoplasty, wedge-shaped compression fractures, acquired kyphosis, general height loss, central crush fracture, bone density loss
Cooper, Lin & Lane 2006