It is evident that we must have admission films of the thoracic spine of each patient if we are to evaluate correctly the question of vertebral fractures subsequent to convulsive therapy. Many of the patients will be found to show evidence of old disease or trauma, such as juvenile osteochondritis, degenerative arthritis, senile changes, and, possibly, fractures from accidental injuries or previous convulsive therapy.
Quite often we see a thoracic spine with exaggerated kyphosis (Fig. 1) which involves most of the middle and lower thoracic vertebral bodies. In such a case we think of this as representing the end-result of healed osteochondritis of childhood (kyphosis dorsalis juvenilis, or Calvé's disease of the spine).* The vertebral bodies present anterior wedging, increasing toward the center of the arch, similar to the appearance of a keystone at the apex. The reduction in vertical height of each involved vertebra is gradual in such cases,
NEWBURY CL, ETTER LE. Clarification of the Problem of Vertebral Fractures from Convulsive TherapyII. Roentgenological Considerations. AMA Arch NeurPsych. 1955;74(5):479-487. doi:10.1001/archneurpsyc.1955.02330170013003