Diagnosis of a vertebral fracture

The diagnosis of a vertebral fracture comprises various aspects, which will be presented here in brief. The first steps in the diagnosis of a vertebral fracture are the clinical examination and the medical history. It is essential for the examiner to know how the fracture may have occurred.

Therefore it is asked whether there was a fall or an accident or any other potentially triggering event. Furthermore, previous illnesses concerning the skeletal system such as osteoporosis or bone tumors are of importance. Certain medications can also promote instability of the bones, so a medication history is also very important.

Furthermore, the doctor will clarify whether there were signs of paralysis, a feeling of numbness or problems with urination or bowel movements. These can be indications of spinal cord damage. For the clinical examination the spine is examined for knocking and pressure pain.

Furthermore, the physician looks for deformities, palpable bone steps or a restriction of movement. The patient’s motor skills and sensitivity are also examined. However, if an unstable fracture is suspected, e.g. after an accident, this is rather counterproductive, so that imaging diagnostics are quickly switched to.

An x-ray of the spine is taken in two planes, in which fracture signs are visible. Bone fragments or other radiological abnormalities can be seen, for example. In the event of an accident, which is likely to have other concomitant injuries, computed tomography (CT) is usually performed to quickly detect any life-threatening injuries.The CT is also used to assess vertebral fractures in the transition region between the cervical spine and thoracic spine and is always performed in the presence of nerve failures.

Magnetic resonance imaging of the spinal column MRI is only performed in rare cases because it takes too long for an accident situation. However, it is certainly useful for planning surgery or when there is suspected injury to nerves, blood vessels, ligaments and soft tissue. Green indicates the lumbar spine. The red LWK 3 indicates a cover plate compression fracture. The sacrum is visible in blue.