Empty vertebral body sign

Radiological sign indicating vertebral body collapse

Empty vertebral body sign
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Synonyms	N/A
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Symptoms
Complications
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Causes	Osteoporosis, Metastatic cancer, Trauma
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Diagnosis	X-ray, CT scan, MRI
Differential diagnosis	N/A
Prevention	N/A
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The empty vertebral body sign is a radiological finding typically observed on X-ray or CT scan imaging of the spine. It is characterized by the appearance of a vertebral body that seems to be devoid of its usual trabecular bone structure, often due to collapse or severe compression. This sign is indicative of underlying pathological processes affecting the vertebrae, such as osteoporosis, metastatic cancer, or trauma.

Pathophysiology

The empty vertebral body sign occurs when the structural integrity of a vertebral body is compromised. This can happen due to:

• Osteoporosis: A condition where decreased bone density leads to weakened bones, making them more susceptible to fractures. Vertebral compression fractures are common in osteoporotic patients, leading to the empty vertebral body appearance.

• Metastatic cancer: Cancer that has spread to the bones can cause lytic lesions, which weaken the vertebrae and may result in collapse.

• Trauma: Acute injury to the spine can cause vertebral fractures, leading to the empty vertebral body sign.

Diagnosis

The empty vertebral body sign is primarily diagnosed through imaging studies:

• X-ray: A plain radiograph can reveal the characteristic appearance of a collapsed vertebral body.

• CT scan: Provides a more detailed view of the bone structure and can help in assessing the extent of the collapse.

• MRI: Useful in evaluating the soft tissue and bone marrow involvement, especially in cases of metastatic disease.

Clinical Significance

The presence of an empty vertebral body sign necessitates further investigation to determine the underlying cause. It is crucial for guiding treatment decisions, which may include:

• Medical management: For osteoporosis, medications such as bisphosphonates may be prescribed to strengthen bones.

• Surgical intervention: In cases of severe compression or instability, surgical procedures like vertebroplasty or kyphoplasty may be considered.

• Oncological treatment: If metastatic cancer is the cause, appropriate cancer therapies such as chemotherapy or radiation may be required.

Also see

• Vertebral compression fracture
• Osteoporosis
• Spinal metastasis
• Radiology