Department of Medicine, University of British Columbia, Vancouver, Canada.
Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco.
Am J Med. 2016 Feb;129(2):221.e1-10. doi: 10.1016/j.amjmed.2015.09.020. Epub 2015 Oct 30.
Vertebral fractures are common and can result in acute and chronic pain, decreases in quality of life, and diminished lifespan. The identification of vertebral fractures is important because they are robust predictors of future fractures. The majority of vertebral fractures do not come to clinical attention. Numerous modalities exist for visualizing suspected vertebral fracture. Although differing definitions of vertebral fracture may present challenges in comparing data between different investigations, at least 1 in 5 men and women aged >50 years have one or more vertebral fractures. There is clinical guidance to target spine imaging to individuals with a high probability of vertebral fracture. Radiology reports of vertebral fracture need to clearly state that the patient has a "fracture," with further pertinent details such as the number, recency, and severity of vertebral fracture, each of which is associated with risk of future fractures. Patients with vertebral fracture should be considered for antifracture therapy. Physical and pharmacologic modalities of pain control and exercises or physiotherapy to maintain spinal movement and strength are important components in the care of vertebral fracture patients.
椎体骨折很常见，可导致急性和慢性疼痛、生活质量下降和寿命缩短。识别椎体骨折很重要，因为它们是未来骨折的有力预测指标。大多数椎体骨折并未引起临床关注。有许多方法可用于观察疑似椎体骨折。虽然不同的椎体骨折定义可能会在比较不同研究的数据时带来挑战，但至少有 1/5 的年龄>50 岁的男性和女性有一个或多个椎体骨折。有临床指南将脊柱成像针对椎体骨折可能性高的个体。椎体骨折的放射学报告需要明确说明患者有“骨折”，并提供进一步的相关细节，如骨折的数量、新近程度和严重程度，这些都与未来发生骨折的风险有关。应考虑对椎体骨折患者进行抗骨折治疗。疼痛控制的物理和药物治疗方法以及锻炼或物理疗法以维持脊柱运动和力量是椎体骨折患者护理的重要组成部分。
