The upper thoracic spine is most commonly affected, of which 50% are asymptomatic. The pain is more prevalent with fractures in the lumbar spine. Progressive
collapse may ensue secondary to avascular necrosis. Patients with thoracic fractures
may experience radicular pain and this always precedes any motor deficit secondary
to cord compression. A neurological deficit or radicular symptoms may develop
weeks or months following the initial fracture. Delayed collapse may be insidious
and progressive. There is no doubt that the posterior cortex of the vertebral body is
more involved than it was previously felt, resulting in the so-called "burst fracture"
(Fig. 5). As a result, all osteoporotic fractures should be followed for a minimum of
1 year. It is important to rule out osteomalacia, particularly in the elderly living in
inner cities or in places where access to regular sunlight may be difficult.