What is the current evidence on vertebral body osteonecrosis? A systematic review of the literature

Matteo Formica, Andrea Zanirato, Luca Cavagnaro, Marco Basso, Stefano Divano, Carlo Formica, Lamberto Felli

Research output: Contribution to journalReview articlepeer-review


Osteonecrosis (ON) is a clinical entity characterized by a pattern of cell death and complex process of bone resorption and formation. Studies related to ON have largely focused on certain anatomical sites; however, the evidence on vertebral body ON (VBON) is largely inconsistent and fragmented. The aim of this study was to clarify the pathophysiology, risk factors, imaging findings, and available treatment modalities for VBON. A systematic review of the relevant articles published in English was performed using PubMed, Embase, Medline, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL databases. A total of 81 articles were included in this study. Three main topics about VBON were identified: (1) pathophysiology and risk factors, (2) diagnosis, and (3) treatment. Forty-five studies were based on the pathophysiology, 52 on diagnosis, and 38 on the treatment options for VBON. The literature on VBON was limited and mainly focused on post-traumatic cases with a considerable overlap with nonunion and pseudoarthrosis.

Original languageEnglish
Pages (from-to)586-599
Number of pages14
JournalAsian Spine Journal
Issue number23
Publication statusPublished - Jun 1 2018


  • Bone necrosis
  • Diagnosis
  • Outcomes
  • Spine
  • Treatment
  • Vertebral body

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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