Vertebral Osteonecrosis

Abstract

Vertebral osteonecrosis (ON) is a rare, underdiagnosed disease, also called pseudarthrosis due to ischemia following a compression fracture (CF). The main features include the air-occupied intravertebral cleft visualized as a radiolucent shade of linear or semilunar X-ray, namely an intravertebral vacuum cleft (IVC) sign. Usually, this phenomenon shows low signal intensity with all magnetic resonance imaging (MRI) sequences. Another feature of ON of the vertebral body is the intravertebral fluid analogous to edema and fibrosis in histological sections. This appears as low signal intensity on T1- weighted MRI, with high signal intensity on T2-weighted images. The risk factors for vertebral ON are multivariate, and the pathophysiological mechanisms are still unknown with certainty.