{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T17:13:05Z","timestamp":1788369185467,"version":"build-2803163510"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HSS Journal\u00ae: The Musculoskeletal Journal of Hospital for Special Surgery"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Progressive radiographic collapse after osteoporotic vertebral fractures (OVFs) may lead to kyphotic deformity. Predictors remain inconsistent, partly because prior studies used heterogeneous conservative treatment protocols that may alter collapse risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Questions\/Purposes:<\/jats:title>\n                    <jats:p>We asked (1) how much vertebral compression progressed after a standardized body-cast protocol, (2) which factors were associated with progression, and (3) whether computed tomography (CT)-detected intravertebral cleft (IVC) independently predicted progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We retrospectively reviewed 162 patients with 202 acute OVFs from a single institution who were treated with early body-cast immobilization followed by rigid bracing between April 2013 and March 2016. Follow-up radiographs obtained 6 to 13\u2009months after injury were used to assess collapse progression, defined as the change in anterior vertebral body compression percentage between baseline and follow-up. Baseline CT and magnetic resonance imaging (MRI) obtained within 2\u2009weeks of injury were used to assess cortical wall fractures, MRI signal patterns, and IVCs. Variables with\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009\n                      <jats:italic toggle=\"yes\">&lt;<\/jats:italic>\n                      \u2009.10 on univariate analysis entered multivariable linear regression models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Mean anterior vertebral body compression percentage increased from 22.2% to 29.0% (mean progression, 6.9%). Vertebrae with IVCs progressed more than those without IVCs (\u22653\u2009mm, 13.8%; 1-&lt;3\u2009mm, 14.0%; none, 4.9%). In multivariable analysis, IVC was the only independent predictor of greater radiographic collapse progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This retrospective observational study found that baseline CT-detected IVC of at least 1\u2009mm identified vertebrae at risk for radiographic collapse progression despite standardized body-cast treatment. This finding should be interpreted as a radiographic risk marker, not direct evidence of treatment failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, retrospective prognostic study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15563316261480114","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T07:55:48Z","timestamp":1788162948000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["CT-Detected Intravertebral Cleft Predicts Radiographic Collapse Progression After Body-Cast Treatment of Acute Osteoporotic Vertebral Fractures"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8642-6613","authenticated-orcid":false,"given":"Yugo","family":"Morita","sequence":"first","affiliation":[{"name":"Adult Reconstruction and Joint Replacement Service, Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA"},{"name":"Department of Orthopedic Surgery, Hayashi Hospital, Echizen, Fukui, Japan"},{"name":"Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazushi","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hayashi Hospital, Echizen, Fukui, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5338-3779","authenticated-orcid":false,"given":"Shigeo","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Kyoto Shimogamo Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Nishitani","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00675"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.2002.17.4.716"},{"key":"e_1_3_3_4_2","doi-asserted-by":"crossref","unstructured":"Johnell O Kanis JA. 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