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Wedging of vertebral bodies at the thoracolumbar junction in asymptomatic healthy subjects on magnetic resonance imaging

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Abstract

Purpose

Wedging of the vertebral body on radiological examination is a valuable indicator of a vertebral compression fracture, although it can also be observed in subjects with no history of trauma. The purpose of this study was to elucidate the normative value of vertebral wedging at the thoracolumbar junction in asymptomatic healthy subjects for differential diagnosis of vertebral compression fractures using MRI.

Methods

A total of 115 subjects without back pain at the time of the examination and without history of spinal trauma was included (68 males, 47 females, mean age 49.5 years). They underwent MRI of the thoracic and lumbar spine, and the ratio of anterior vertical height to posterior vertical height of the vertebral body (APR) was determined from T10 to L2 on T2 weighted sagittal images.

Results

APR was 0.92 ± 0.08 at T10, 0.92 ± 0.08 at T11, 0.90 ± 0.06 at T12, 0.89 ± 0.06 at L1, and 0.90 ± 0.07 at L2, indicating that vertebral bodies at the thoracolumbar junction appear wedge-shaped rather than rectangular. Males, thinner subjects, smokers, and subjects with abnormalities of the endplates such as a Schmorl nodule had a significantly smaller APR than females, fatter subjects, non-smokers, and those without endplate abnormalities.

Conclusion

The normative values of APR obtained in the present study can represent a valuable reference in the diagnosis of vertebral compression fracture to help prevent confusion with physiological vertebral wedging.

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Acknowledgments

We express our cordial thanks to Mr. Toshio Watanabe at the Central Radiotechnology Department of Keio University Hospital, for their cooperation for this study. This study was supported by a grant from the General Insurance Association of Japan. Kazuhiro Chiba has received honorarium from the General Insurance Association of Japan for workshop. Morio Matsumoto has received honorarium from the General Insurance Association of Japan for workshop.

Conflict of interest

The other authors have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Keio University, Shinanomachi 35, Shinjuku-ku, 160-8582, Tokyo, Japan

    Morio Matsumoto, Eijiro Okada, Yasuhito Kaneko, Daisuke Ichihara, Kazuhiro Chiba & Yoshiaki Toyama

  2. Department of Advanced Therapy for Spine and Spinal Cord Disorders, Keio University, Shinjuku-ku, Japan

    Kota Watanabe

  3. Department of Diagnostic Radiology, Keio University, Shinjuku-ku, Japan

    Hirokazu Fujiwara & Suketaka Momoshima

  4. Department of Preventive Medicine and Public Health, Keio University, Shinjuku-ku, Japan

    Yuji Nishiwaki

  5. Department of Orthopaedic Surgery, Keio University Tsukigase Rehabilitation Center, Keio University, Shinanomachi 35, Shinjuku-ku, 160-8582, Tokyo, Japan

    Takeshi Hashimoto

  6. Department of Orthopaedic Surgery, Isehara Kyodo Hospital, Isehara, Japan

    Takeshi Takahata

Authors
  1. Morio Matsumoto
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  2. Eijiro Okada
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  3. Yasuhito Kaneko
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  4. Daisuke Ichihara
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  5. Kota Watanabe
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  6. Kazuhiro Chiba
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  7. Yoshiaki Toyama
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  8. Hirokazu Fujiwara
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  9. Suketaka Momoshima
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  10. Yuji Nishiwaki
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  11. Takeshi Hashimoto
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  12. Takeshi Takahata
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Corresponding author

Correspondence to Morio Matsumoto.

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Matsumoto, M., Okada, E., Kaneko, Y. et al. Wedging of vertebral bodies at the thoracolumbar junction in asymptomatic healthy subjects on magnetic resonance imaging. Surg Radiol Anat 33, 223–228 (2011). https://doi.org/10.1007/s00276-010-0746-x

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  • DOI: https://doi.org/10.1007/s00276-010-0746-x

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