Comprehensive Spine and Vertebral
Disorders Review: Causes, Imaging,
Diagnosis, and Treatment of
Compression Fractures, Spondylolysis,
DISH, Scheuermann’s Disease, and
Trauma-Related Spinal Injuries
Questions Verified and Complete with A+
Graded Rationales Latest Updated 2026
Vertebral compression fracture
Loss of axial body height
Causes:
- trauma (falling on bottom, sudden hyperflexion)
- osteoporosis
- pathologic fracture (metastasis, osteomyelitis)
Xray:
- lateral radiographs
- MRI (if cant see in radiograph)
- bone scintigram to determine age (old or new)
- CT Scan (if suspected neurological symptoms as well)
loss of axial body height =
vertebral compression fracture
What procedure helps with compression fractures?
percutaneous vertebroplasty
- basically inserting cement (methyl-methacrylate) into the vertebral body
***helps relieve symptoms and quality of life
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, chance fracture
hyper flexion AND shearing injury
- horizontal fracture with posterior elements (3 column fracture = very unstable)
***classically seen with an MVA where victim is wearing a seatbelt without shoulder harness
- make sure to get abdominal CT on these PTs
A PT presents to the ER following a MVA. The PT reports back pain and after further
investigation you are told they were incorrectly wearing their seatbelt without the shoulder
strap. What fracture are you anticipating to see on Xray?
Chance fracture
- hyperflexion, shearing injury
- Unstable fracture
- Horizontally oriented fracture through vertebral body AND posterior elements
- 50% associated with visceral abdominal injuries
- Need abdominal CT scan
**horizontal fracture on X-ray
What fracture is a horizontal fracture as a result of a hyperflexion shearing injury?
chance fracture
Fracture dislocation
high velocity trauma injury
- Many have head, organ,MSK injuries
- hyperflexion, rotation, and shearing forces
- MRI needed to evaluate cord injuries
**spinal cord injuries in most patients
Spondylolysis
fracture of pars interarticularis ("scotty dog")
- stress fracture usually of L5
***50% of all back pain in adults***
2|Page
Disorders Review: Causes, Imaging,
Diagnosis, and Treatment of
Compression Fractures, Spondylolysis,
DISH, Scheuermann’s Disease, and
Trauma-Related Spinal Injuries
Questions Verified and Complete with A+
Graded Rationales Latest Updated 2026
Vertebral compression fracture
Loss of axial body height
Causes:
- trauma (falling on bottom, sudden hyperflexion)
- osteoporosis
- pathologic fracture (metastasis, osteomyelitis)
Xray:
- lateral radiographs
- MRI (if cant see in radiograph)
- bone scintigram to determine age (old or new)
- CT Scan (if suspected neurological symptoms as well)
loss of axial body height =
vertebral compression fracture
What procedure helps with compression fractures?
percutaneous vertebroplasty
- basically inserting cement (methyl-methacrylate) into the vertebral body
***helps relieve symptoms and quality of life
1|Page
, chance fracture
hyper flexion AND shearing injury
- horizontal fracture with posterior elements (3 column fracture = very unstable)
***classically seen with an MVA where victim is wearing a seatbelt without shoulder harness
- make sure to get abdominal CT on these PTs
A PT presents to the ER following a MVA. The PT reports back pain and after further
investigation you are told they were incorrectly wearing their seatbelt without the shoulder
strap. What fracture are you anticipating to see on Xray?
Chance fracture
- hyperflexion, shearing injury
- Unstable fracture
- Horizontally oriented fracture through vertebral body AND posterior elements
- 50% associated with visceral abdominal injuries
- Need abdominal CT scan
**horizontal fracture on X-ray
What fracture is a horizontal fracture as a result of a hyperflexion shearing injury?
chance fracture
Fracture dislocation
high velocity trauma injury
- Many have head, organ,MSK injuries
- hyperflexion, rotation, and shearing forces
- MRI needed to evaluate cord injuries
**spinal cord injuries in most patients
Spondylolysis
fracture of pars interarticularis ("scotty dog")
- stress fracture usually of L5
***50% of all back pain in adults***
2|Page
