Retrospective Review of 181 Patients with Pathologic Vertebral Compression Fractures

Background: Compression fractures are often associated with lower energy trauma and may occur in the setting of abnormal bone health genetic disorders endocrine disorders, neoplastic disease, infection, inflammatory disorders. There is no significant series literature describing prevalence or etiology pathologic pediatric compression fractures. Methods: IRB-approved retrospective study was performed at a tertiary children’s hospital from 2012-2022. Patients <18 years old diagnosed atraumatic vertebral were included reviewed for demographics, underlying diagnosis/comorbidity, presentation, mobility, deformities, imaging data, treatments, outcomes. Results: 181 patients (54% Male) mean age 14.17 follow-up 20 months. A fracture presenting symptom an diagnosis 32% patients. Primary osteoporosis cause 15%, secondary 65% patients; primarily due to immunosuppressants (46%) ALL (10%). lesions 20% median 3 per patient, mostly midthoracic (82%) thoracolumbar spine (51%). Radiographs revealed wedge 82% vertebra plana 11%. managed careful observation bracing (78%) only 6% received operation. By last follow-up, more developed scoliosis wheelchair-bound. Overall, there 16% mortality rate which cancer. Conclusion: About presented as disease. Pathologic children frequently occurred immunosuppressants, ALL, metastatic The non-structural mid-thoracic regions spine. MRI’s be useful distinguishing between benign malignancy. Most treated by observation, but kyphosis necessary.