Guideline Files


Guidelines on Diagnosis and Management of Osteoporosis

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Atypical Femoral Fractures

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Vertebral factures

Vertebral fractures are associated with major trauma and are of the thoracic and lumbar spine. They can cause spinal cord damage, resulting in neural deficits.

Symptoms and signs

Signs and symptoms of vertebral facture can include pain or neural deficits developing, including:

  • Numbness
  • Weakness
  • Neurogenic shock
  • Tingling
  • Spinal shock

Laboratory and imagery studies are performed on patients with vertebral fracture, including:

  • Urinalysis or urine dip for blood
  • Amylase and lipase levels
  • Cardiac-marker levels
  • Urine myoglobin and serum creatine kinase levels
  • Serum calcium level
  • Pregnancy test
  • Radiography
  • Computed tomography (CT) scanning
  • Magnetic resonance imaging (MRI)

Nonsurgical fracture management

Minor fractures are treated without surgery. A spinal orthotic vest or brace to prevent rotational movement and bending can be used to manage unstable spine fractures. Patients with spinal cord injuries and paraplegia need to be stabilised sufficiently – especially for their upper body, to allow for proper rehabilitation.Surgery is used to stabilise the disrupted vertebral column and assist with decompressing the spinal cord canal.

Basic surgery approaches used, include:

  • Posterior approach, which involves the fixation of the posterior bony elements.
  • Posterolateral approach, which is often used for high thoracic fractures such as T1 through
  • Anterior approach, which allows access to the vertebral bodies at multiple levels.