Osteoporotic vertebral fractures: an update

Open Access

Review

Table 1

Summary of osteoporotic vertebral fractures classification systems.

Method	Characteristics	Examples	Description	Advantages	Disadvantages	Use
Quantitative	Measurement of height or surface without assessment of vertebral morphology	Eastell et al. [11]	Eastell et al.: three types of fractures depending on the decreased vertebral height (wedge, biconcave, crush fracture)	Objective, reproducible, use in automatized algorithms	High number of false positives and false negatives	Automated diagnosis, research
Quantitative		McCloskey et al. [12]	McCloskey et al.: further classification of the wedge type into anterior and posterior	Objective, reproducible, use in automatized algorithms	High number of false positives and false negatives	Automated diagnosis, research
Qualitative	Step-by-step analysis focused on vertebral abnormalities; exclusion of abnormalities caused by conditions other than OVF	Sugita et al. [13]	Classification of OVFs into five types according to morphology: type I (swelled-front), type II (bow-shaped), type III (projecting), type IV (concave), type V (indented)	Diagnosis of OVF without significant loss of vertebral height	Need for trained observer	Daily clinical practice
Combined	Description of the vertebral morphology combined with quantification of height or surface loss	Genant et al [14]	Genant et al.: determination of vertebral height or surface loss (degrees 0–3), 3 types of morphological deformity (wedge, biconcave, crush)	Simplicity, high inter- and intra-observer agreement	Confusion with anatomical variants and other conditions, need for trained observers	Daily clinical practice, research
Combined		DGOU classification [15]	DGOU: Classification of OVFs into five types, according to CT and MRI findings	Simplicity, high inter- and intra-observer agreement		Daily clinical practice, research

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