History: 50 year old male with chronic lower back pain. 

This is an anterior compression fracture of the L1 vertebral body. Typically in this location these fractures are due to trauma with an axial loading force on the vertebral body. In fact, 50-65% of traumatic spine compression fractures occur between T12 and L2, the junction of the thoracic and lumbar spine. In the setting of osteoporosis, compression fractures can occur at any level. In the case above, the posterior elements are unaffected. In the setting of distraction of the posterior elements and anterior compression, the diagnosis would be a Chance fracture.