Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

Sadiqi, Said; Verlaan, Jorrit Jan; Lehr, A. Mechteld; Dvorak, Marcel F.; Kandziora, Frank; Rajasekaran, Shanmuganathan; Schnake, Klaus John; Vaccaro, Alexander R.; Öner, F. Cumhur

doi:10.1007/s00586-016-4716-9

Cited by 41 publications

(28 citation statements)

References 25 publications

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“…The definition and measurement methods for these two important imaging parameters are still controversial, and no conclusion has been reached thus far [7]. Previously, researchers used different measurement methods to assess the degree of vertebral body collapse by using posterior wall height as the reference vertebral body compression ratio (VBCR) or the percentage of anterior height compression (PAHC), which uses the mean height of segments adjacent to a healthy vertebral body as the reference value [8–11]. However, differences in the range of vertebral body collapse may result in measurement errors.…”

Section: Introductionmentioning

confidence: 99%

The Evaluation of Different Radiological Measurement Parameters of the Degree of Collapse of the Vertebral Body in Vertebral Compression Fractures

Hsu

Chen

et al. 2019

Applied Bionics and Biomechanics

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For compression fracture, vertebral body height loss (VBHL) and kyphotic angle (KA) are two important imaging parameters for determining the prognosis and appropriate treatment. This study used previous measurement methods to assess the degree of VBHL and KA, compare and examine differences between various measurement methods, and examine the correlation between relevant measurement parameters and intravertebral cleft (IVC) in the vertebral body. The radiographic images (lateral view of the T-L spine) of 18 patients with a single-level vertebral compression fracture were reviewed. We measured 9 characteristic lengths and angles on plain radiographs, including anterior vertebral height (AVH) and AVH of the adjacent upper and lower levels, middle vertebral height (MVH) and MVH of the adjacent upper and lower levels, posterior vertebral height (PVH), and vertebral body width, and assessed 6 parameters, including vertebral compression ratio (VBCR), percentage of anterior height compression (PAHC), percentage of middle height compression (PMHC), kyphotic angle (KA), calculated kyphotic angle (CKA), and IVC. The results showed that VBCR is a simple and rapid method of VBHL assessment, but it may result in an underestimation of the degree of VBHL compared to PAHC. When PMHC<40% or kyphotic angle>15°, the probability of IVC occurring on the vertebral body was higher which means the higher risk of vertebral body instability. The results of this study could provide a reference for surgeons when using imaging modalities to assess the degree of vertebral body collapse.

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Section: Introductionmentioning

confidence: 99%

The Evaluation of Different Radiological Measurement Parameters of the Degree of Collapse of the Vertebral Body in Vertebral Compression Fractures

Hsu

Chen

et al. 2019

Applied Bionics and Biomechanics

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“…Also, 'Radiographic sagittal Table 4 Inter-rater agreement for the total score of the AOSpine CROST using intraclass correlation coefficient, both for the short term and long term ICC intraclass correlation coefficient Assessment ICC Non-surgical (short term) 0.56 Non-surgical (long term) 0.52 Surgical (short term) 0.60 Surgical (long term) 0.54 alignment' was not specified in terms of specific kyphosis angles as to their impact on outcomes, as various threshold definitions have been proposed in previous literature [17,18]. Moreover, worldwide variation of measurement techniques by surgeons around the world has made creation of specific numeric levels undesirable [19]. The parameter of 'Stability of the injured spine level' was further refined by addition of the term 'mechanical instability'.…”

Section: Discussionmentioning

confidence: 99%

Development and reliability of the AOSpine CROST (Clinician Reported Outcome Spine Trauma): a tool to evaluate and predict outcomes from clinician’s perspective

et al. 2020

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Purpose To report on the development of AOSpine CROST (Clinician Reported Outcome Spine Trauma) and results of an initial reliability study. Methods The AOSpine CROST was developed using an iterative approach of multiple cycles of development, review, and revision including an expert clinician panel. Subsequently, a reliability study was performed among an expert panel who were provided with 20 spine trauma cases, administered twice with 4-week interval. The results of the developmental process were analyzed using descriptive statistics, the reliability per parameter using Kappa statistics, inter-rater rater agreement using intraclass correlation coefficient (ICC), and internal consistency using Cronbach’s α. Results The AOSpine CROST was developed and consisted of 10 parameters, 2 of which are only applicable for surgically treated patents (‘Wound healing’ and ‘Implants’). A dichotomous scoring system (‘yes’ or ‘no’ response) was incorporated to express expected problems for the short term and long term. In the reliability study, 16 (84.2%) participated in the first round and 14 (73.7%) in the second. Intra-rater reliability was fair to good for both time points (κ = 0.40–0.80 and κ = 0.31–0.67). Results of inter-rater reliability were lower (κ = 0.18–0.60 and κ = 0.16–0.46). Inter-rater agreement for total scores showed moderate results (ICC = 0.52–0.60), and the internal consistency was acceptable (α = 0.76–0.82). Conclusions The AOSpine CROST, an outcome tool for the surgeons, was developed using an iterative process. An initial reliability analysis showed fair to moderate results and acceptable internal consistency. Further clinical validation studies will be performed to further validate the tool.

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“…A new comprehensive AO classifi cation system was more recently proposed depending only on fracture morphology and neurological status [26,27].…”

Section: Discussionmentioning

confidence: 99%

Validity of radiographic measurements in classifi cation of Thoracolumbar injuries: Statistical analysis

Aly¹,

ElGazzar²

2019

Int J Spine Res

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Introduction:Although there are many classifi cation systems for assessing the thoracolumbar injuries, it is of paramount importance to make the right clinical decision in treatment of thoracolumbar injuries is to precisely measure the radiographic vertebral parameters. Previous reports described the various radiologic parameters and the measuring techniques. The available radiologic parameters assess the following parameters in the injured spine: Sagittal alignment, vertebral body compression, and spinal canal dimensions. Another problem is different measuring techniques for those parameters which add more confusion in data collection that refl ect on the decision making.Aim: In this study, we criticize the role of the three columns theory in classifi cation of thoracolumbar injuries, if the number of the columns affected correlate with the fracture type, instability and management results. Also, if the measured radiologic parameters from the lateral view of injured vertebra correlate with the type of the fracture. Material and Methods:In this retrospective quantitative case study, X-rays, CTs and MRI of thoracolumbar injured spine in 74 patients in the period from 2012 to 2016 were evaluated. Pathologic spinal fractures or vertebral appendices fractures were excluded from the study. All fractures were classifi ed using three columns theory by Denis. The radiographic parameters evaluated were: Sagittal alignment using Cobb's angle, vertebral compression, and spinal canal compression.Results: Loss of vertebral heights especially anterior height was found to be signifi cant in relation to the fracture type. Spinal canal narrowing and vertebral displacement and compression were found signifi cance in relation to preoperative Frankel's grading.Conclusion: Not all radiographic parameters previously used for assessment of thoracolumbar injuries were correlated with the fracture type, number of spinal columns or forces applied. The most important parameters that put into consideration in evaluation of thoracolumbar fractures are anterior vertebral height, percentage of spinal canal narrowing, percentage of vertebral displacement.

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Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

Cited by 41 publications

References 25 publications

The Evaluation of Different Radiological Measurement Parameters of the Degree of Collapse of the Vertebral Body in Vertebral Compression Fractures

The Evaluation of Different Radiological Measurement Parameters of the Degree of Collapse of the Vertebral Body in Vertebral Compression Fractures

Development and reliability of the AOSpine CROST (Clinician Reported Outcome Spine Trauma): a tool to evaluate and predict outcomes from clinician’s perspective

Validity of radiographic measurements in classifi cation of Thoracolumbar injuries: Statistical analysis

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