Post-traumatic findings of the spine after earlier vertebral fracture in young patients: clinical and MRI study.
METHODS
A study comparing magnetic resonance imaging findings of degenerative changes in intervertebral discs in young patients with previous wedge-shaped compression fracture and age-matched and sex-matched control subjects.


OBJECTIVE
To find out the role of fractures in disc degeneration and to assess the clinical outcome of the patients.


BACKGROUND
Several experimental studies have postulated that trauma is one of the major reasons for disc degeneration. Wedge compression fractures in vertebrae of children have been considered insignificant, but this has not been verified in the literature.


METHODS
Fourteen patients 8.8 to 20.8 years of age (mean, 15.5 years) with a history of wedge-shaped vertebral compression fracture at least 1 year previously (mean, 3.8 years) and asymptomatic healthy control subjects were studied by thoracolumbar spine magnetic resonance imaging. The patients also underwent a clinical examination.


RESULTS
Eight (57%) of the 14 patients had disc degeneration, and seven of them had it at the trauma level. Of these 7 subjects, 6 also had endplate damage at this level. The association between endplate damage and adjacent intervertebral disc degeneration was significant (P < 0.01). Only 2 of the patients were symptomatic. In the control group, only 1 subject had disc degeneration with endplate changes and disc herniation.


CONCLUSIONS
The patients had more disc degeneration than did those in the control group. Endplate injury was strongly associated with disc degeneration. No correlation between previous vertebral fracture and back pain was seen in this study.
Kerttula
L I
LI
Departments of Diagnostic Radiology, Pediatrics, and Physical Medicine and Rehabilitation, University of Oulu, Finland. Liisa.Kerttula@oulu.fi
Serlo
W S
WS
Tervonen
O A
OA
Pääkkö
E L
EL
Vanharanta
H V
HV
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000293:injuries; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000175:diagnosis* / Q000000981:diagnostic imaging; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries