On x-ray: note the general osteoporotic spine. Of key importance is the decrease in vertical height of both the T11 and L1 vertebral bodies, as seen on the AP projection. No lateral thoracic was submitted, but the lateral lumbar clearly shows complete collapse of L1. The important feature is decreased posterior body height. This helps differentiate this fracture from a simple osteoporotic compression fracture, also common in this same age group. Due to a greater amount of trabeculation in the posterior aspect of a vertebral body, an osteoporotic vertebral body classically presents as trapezoidal on a lateral film, demonstrating anterior wedging. A pathological collapse, as in this patient, will additionally demonstrate decreased posterior body height, not a good sign. I recommended a bone scan as soon as possible to further evaluate the entire skeletal status.
As an interesting aside, you may remember that metastasis from a prostate primary is classically blastic, but tumors don’t read the textbooks!