title: Wedging of vertebral bodies at the thoracolumbar junction in asymptomatic healthy subjects on magnetic resonance imaging.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopaedic Surgery, Keio University, Tokyo, Japan. morio@sc.itc.keio.ac.jp
authors.forename: Morio
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Eijiro
authors.initials: E
authors.lastname: Okada
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichihara
authors.forename: Kota
authors.initials: K
authors.lastname: Watanabe
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Chiba
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Toyama
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Suketaka
authors.initials: S
authors.lastname: Momoshima
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishiwaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Takahata
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D050815:Fractures, Compression / Q000175:diagnosis*; D006801:Humans; D008159:Lumbar Vertebrae / Q000033:anatomy & histology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D016103:Spinal Fractures / Q000175:diagnosis*; D013904:Thoracic Vertebrae / Q000033:anatomy & histology*; D055815:Young Adult