Rebound-associated vertebral fracture

Physical Exam

• Percussion tenderness on vertebrae
  • Acute pain = Relatively acute fracture
  • General discomfort = OP
• Changes in height
  • Prospective height shortens > 2 cm
  • Historical height shortens > 5 cm
  • Rib-to-pelvis distance ≤ 2 fingers
  • Occiput-to-wall distance ≥ 5 cm
    • Shoulder to the wall
    • Earlobe in front of clavicle
    • (<40 should be 0)
    • *Change over time is important

Test

VSA

Genant classification of vertebral fractures

• based on the vertebral shape, with respect to vertebral height loss involving the anterior, posterior, and/or middle vertebral body.
  • grade 0: normal
  • grade 1: mild fracture, <25% loss of height
  • grade 2: moderate fracture, 25% to 40% loss of height
  • grade 3: severe fracture, >40% loss of height
  • Labels