The lumbar vertebral bodies are the largest in the mobile spine, supporting the full weight of the trunk, head, and arms above. Their kidney-shaped cross-section with a flat anterior border and concave posterior border provides the structural geometry that maintains the spinal canal and supports the intervertebral discs. The vertebral body endplates are the weakest point under axial compression, failing before the disc in young patients (endplate fractures from axial loading).
Vertebral compression fractures of the lumbar bodies from osteoporosis are the most common osteoporotic fracture, producing acute back pain that may be confused with muscular back pain. T12 and L1 are the most common levels. Kyphoplasty and vertebroplasty (injecting bone cement into the fractured body) provide pain relief; traditional conservative management with bracing is used for stable fractures. The posterior vertebral body wall is a landmark in spinal surgery — bone from this location retropulsed into the spinal canal causes neurological compromise in burst fractures.
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