What do the following mean in laymans terms?  "subacute compression
fracture of the eighth thoracic verterbral body with approximately 50%
loss of vertical stature at the anterior margin and low grade
retropulsion ofthe posterior cortex.  There is no bone marrow lesion
save for a benign vertebral body hermangioma at T2" (Thoracic Spine)

Hello Poco,

I hope this doesn't refer to *you*!  If it does, you have my sympathy!
 Compression fractures *hurt* - I've had one for years in my lower
back, and it's no fun at all.

Let's break this into smaller pieces first, to help you understand all
of the medicalese:

Thoracic spine:  The twelve vertebrae between your neck and lower
back. These are  numbered T1 through T12, with T1 being the first one
right after the base of your neck (the eighth from the top).

Skeletal Spine (picture)
http://www.nlm.nih.gov/medlineplus/ency/imagepages/1116.htm

Thoracic spine (picture)
http://www.nlm.nih.gov/medlineplus/ency/imagepages/1774.htm

Subacute:

Between acute (having a short and relatively severe course) and
chronic (persisting over a long period of time).  Also, requiring
specialized care.

Subacute
http://cancerweb.ncl.ac.uk/cgi-bin/omd?query=subacute&action=Search+OMD

What does subacute mean?
http://www.subacutenet.com/main-subacute-faq.html#question 3

Compression fracture:  A compression fracture occurs when a vertebra
collapses in on itself (compresses)and shrinks in height.  In even
shorter terms:  It's squashed to half its height.

Compression fracture
http://www.dynomed.com/encyclopedia/encyclopedia/spine/Compression_Fracture.htm

Anterior margin - the front edge (the portion at the front of the
vertebra, facing into the body)

Retropulsion:  a pushing back. 

Retropulsion
http://cancerweb.ncl.ac.uk/cgi-bin/omd?query=retropulsion&action=Search+OMD

In this instance, it's referring to the spinal cortex (covering of the
spinal cord).  The compression fracture is causing part of the
posterior (towards the back of the body) spinal cortex to be pushed
slightly backwards, causing it to bulge.

Lesion:  an injury or tissue loss.  There is apparently no loss of (or
injury to) bone marrow tissue here.

Lesion
http://cancerweb.ncl.ac.uk/cgi-bin/omd?query=lesion&action=Search+OMD

Hemangioma:  a small cluster of blood vessels (think "strawberry
hemangioma", the name for a birthmark caused by a cluster of swollen
capillaries at the skin's surface).  This is a fairly non-specific
term, and is describing a benign (harmless) cluster of blood vessels
on the eighth vertebra.

Hemangioma
http://www.emedicine.com/cgi-bin/foxweb.exe/searchengine@/em/searchengine?boolean=and&book=all&maxhits=100&HiddenURL=&query=Hemangioma

To double check all of my references, I called my friend Jeff, an
MD/PhD (physician scientist!) candidate at the University of Michigan
Medical School.  Jeff was kind enough to translate thusly:

"> "subacute compression
> fracture of the eighth thoracic verterbral body with approximately
50%
> loss of vertical stature at the anterior margin

The body of the # eight thoracic veterbra is crushed vertically to
half it's
normal height in front....

> and low grade
> retropulsion ofthe posterior cortex.

And it bulges backwards somewhat.

> There is no bone marrow lesion
> save for a benign vertebral body hermangioma at T2" (Thoracic Spine)

This part is difficult --because I have no idea what the guy who wrote
the diagnosis was actually looking for. "Bone marrow Lesion" is not at
all informative to me. "Benign vertebra body hemangioma" is equally
not specific --it just means there's a little tangle of blood vessels
up at thorasic vertebra #2 that the doctor somehow thinks is nothing
to worry about."

Poco, I hope this is easier for you to understand than all of the
medical jargon, and I do hope that this isn't your injury!  If it is,
I wish you a speedy recovery!

If you need further assistance, please don't hesitate to ask, I'll be
glad to help you!  As ever, for more specific medical advice, be
certain to consult your physician.

With best wishes,

--Missy

Search terms:  defined in the body of the answer.

In simple terms it means the vertebra in question is squeezed to one
half its normal height on its front side, and that the squeezing has
pushed some of the inside of the bone backward. Subacute implies the
process didn't just happen; meaning there is probably some evidence of
repair going on. Hemangiomas are benign growths of blood vessels, can
occur anywhere (on the skin, they are called birthmarks, among other
things) and are almost always of no significance -- just something
noticed. The causes of compression fracture are several: injury,
osteoporosis (bone loss of calcium for various reasons), tumor.
Reference to bone marrow lesion is probably a way of addressing
whether or not there's a suggestion that the compression could be due
to tumor; by saying there's no bone marrow lesion, the radiologist is
saying there's not that particular evidence of tumor.

And to amplify the marrow thing....if tumor is in a vertebra, it
nearly always got there from somewhere else, via the blood stream. The
marrow has by far more blood circulation than other parts of bone, so
spread tumor (metastases) end up in the marrow, as a rule.

One more thing: in re-reading the original answer, I find the
following:
"
In this instance, it's referring to the spinal cortex (covering of the
spinal cord).  The compression fracture is causing part of the
posterior (towards the back of the body) spinal cortex to be pushed
slightly backwards, causing it to bulge.
 
Lesion:  an injury or tissue loss.  There is apparently no loss of (or
injury to) bone marrow tissue here."


 This is not really accurate, as you  hopefully can gather from my
first response.  "Spinal cortex" is not the covering of the spinal
cord. The report does not suggest there is bulging of the cord.
Likewise, the reference to lack of a bone marrow lesion is not to say
that there is no loss of bone marrow tissue: rather it's saying that
there's no lesion (abnormality) of the bone marrow, which, as I said,
is a reference to signs of tumor....

I think you mean "reference to lack of tumor", yes?

In any case, the customer sought a translation from medicalese into
English, which he was given, with references, illustrations and a
complete double check and translation from someone in the medical
field.  I'm confident the customer will be pleased to have plain
English in front of him.

Google Answers is an inappropriate venue for diagnoses of any sort -
any further questions from the patient should be answered by the
physician handling his care, as has been noted in the answer.

I've seen you about on many of the medical- related questions, and
would be interested in knowing your credentials.

--Missy

I don't believe I was giving a diagnosis; just a translation of the
terminology, and a couple of corrections. Your friend stated he didn't
know the meaning of the lack of a bone marrow lesion, and I believe I
clarified that as well. As to credentials, I have been a practicing
general surgeon in the US since finishing my training and military in
1977. I am a Fellow of the American College of Surgeons, a diplomate
of the American Board of Surgery, and am listed in the "guide to top
doctors,'' published by The Center for the Study of Services, in 1999.
I am semi-retired, and have the time to help where I can.

I suspect you may have misunderstood what my friend meant - his
comment that "bone marrow lesion" wasn't informative to him was meant
in the context of not knowing the patient's full case, "lesion" being
a rather non-specific term.  He didn't know what the physician was
originally looking for, and thus didn't want to offer any guesses.

Was your medical training done in the course of your military service,
or prior to it?  Do you mind if I ask where you went to Med School?

No particular reason for asking, just curiosity.

--Missy