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Avascular Necrosis

Avascular Necrosis

Avascular necrosis, also known as AVN or osteonecrosis, is the cellular death of bone caused by a diminished blood supply. It is fairly common in the joints of the legs and other extremities, but extremely rare within the spine. Patients who do suffer from spinal avascular necrosis have usually experienced a traumatic injury or spinal degeneration that has produced compression fractures of one or more vertebrae.

Risk Factors for Avascular Necrosis

Some people think of the skeletal frame as independent from the body’s circulatory system. However, bone tissue is alive. It is continuously reabsorbed and replaced to maintain mineral balance. Without proper blood flow, bone tissue permanently breaks down and collapses. This is also true within the various joints of the body, where articular surfaces depend on the proper moisture content of cartilage and the overall integrity of the underlying bone. Activities that contribute to the potential development of avascular necrosis include:

  • Steroid use
  • Excessive alcohol consumption
  • Smoking
  • Scuba diving
  • Thrombosis
  • Hypertension


Avascular necrosis is permanent cell death. The goal of early treatment is to prevent avascular necrosis by restoring blood supply. This may be accomplished by reducing pressure on the bone, thereby allowing for greater blood flow. Ultimately, most patients with AVN will need surgery. The hip joints are most commonly affected by this condition, often leading to hip replacements

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