Vertebral deformities and the underlying diseases

The purpose of this review was to summarise the causes of vertebral deformity. Osteoporosis as the most frequent disease lies in the background of vertebral deformity which is the most common type of fractures. Vertebrae cannot resist mechanical loadings so they deform and/or break because of their decreased mineral density and changed trebecular microarchitecture. The diagnosis of vertebral deformity presents several problems in the practice. For example, patients with vertebral fractures do not report having symptoms even when present (asymptomatic deformity), moreover plain radiograph does not show high enough sensitivity to diagnose vertebral fractures. The two methods most likely used in clinical research would be the semiquantitative assessment of vertebral deformities, which is based on visual evaluation, and the quantitative approach, which is based on different morphometric criteria. Absorptiometric morphometry and digital technology are developing, though presently they are not widespread. The compression of vertebrae is followed by heavy pain and functional disability (symptomatic deformity), and in these cases plain radiographs show the following pictures: wedge, biconcave and crush deformity, which enable us to make the diagnosis. Its high occurrence, the increased mortality rate, the decreasing quality of life and the prevalence of subsequent fracture make osteoporotic vertebral deformity so significant. The bone strength is determined not only by bone mass and bone microarchitecture, but also by its quality and turnover. From this follows that besides osteoporosis there are several diseases with vertebral deformity and increased fragilibility. The main diseases are: developmental disorders, osteochondrosis, heritable disorders, postural conditions, traumas, inflammatory diseases, storage diseases, other metabolic bone diseases, hematological diseases and spondyloarthropathy.