Reliability Analyses of Radiographic Measures of Vertebral Body Height Loss in Thoracolumbar Burst Fractures

Jae Young Hong, Sung Woo Choi, Gi Deok Kim, Hyun Kwon Kim, Byung Joon Shin, Eung Ha Kim, Jae Chul Lee, Jin Sung Park, Hae Dong Jang

Research output: Contribution to journalArticle

Abstract

Objective: In thoracolumbar (TL) burst fractures, vertebral body height loss (VBHL) indicates the degree of instability and constitutes one of the decision criteria for surgical treatment. However, the relative reliability and variability of different measurement techniques for VBHL are unknown. We compared the reliability of different methods used to assess VBHL. Methods: A total of 144 patients with TL burst fractures were included, and lateral radiographs were taken twice at an interval of 2 weeks, which were examined by 3 observers. The measurement methods used included the anterior/posterior vertebral body height compression ratio (APCR), anterior height compression percentage (AHCP), and anterior/posterior vertebral body height compression ratio percentage. To compare the accuracy of measurements according to vertebral degeneration, subjects were divided into 2 groups based on the median age of 50 years. Results: In intraobserver comparisons, the APCR method showed a higher inter- and intraclass correlation coefficient (ICC) (>0.714) compared with the other methods. In interobserver comparisons, the ICC of the APCR (>0.793) was excellent. In intraobserver comparisons of the aged >50-years group, only the APCR method showed an excellent ICC (>0.753), whereas the AHCP method showed a fair to good ICC, and the anterior/posterior vertebral body height compression ratio percentage method had the lowest ICC. In interobserver comparisons of the aged >50-years group, the APCR and AHCP methods showed excellent ICCs. In the aged ≤50-years group, all 3 methods showed similar fair to good ICC values. Conclusions: Based on comparative reliability analyses, we recommend the APCR method as the first-line technique and the AHCP as an alternative technique for measuring VBHL in TL burst fractures.

Original languageEnglish
Pages (from-to)e191-e198
JournalWorld Neurosurgery
Volume129
DOIs
Publication statusPublished - 2019 Sep

Fingerprint

Body Height

Keywords

  • Burst fracture
  • Compression ratio
  • Measurement
  • Reliability
  • Vertebral body height loss

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Reliability Analyses of Radiographic Measures of Vertebral Body Height Loss in Thoracolumbar Burst Fractures. / Hong, Jae Young; Choi, Sung Woo; Kim, Gi Deok; Kim, Hyun Kwon; Shin, Byung Joon; Kim, Eung Ha; Lee, Jae Chul; Park, Jin Sung; Jang, Hae Dong.

In: World Neurosurgery, Vol. 129, 09.2019, p. e191-e198.

Research output: Contribution to journalArticle

Hong, Jae Young ; Choi, Sung Woo ; Kim, Gi Deok ; Kim, Hyun Kwon ; Shin, Byung Joon ; Kim, Eung Ha ; Lee, Jae Chul ; Park, Jin Sung ; Jang, Hae Dong. / Reliability Analyses of Radiographic Measures of Vertebral Body Height Loss in Thoracolumbar Burst Fractures. In: World Neurosurgery. 2019 ; Vol. 129. pp. e191-e198.
@article{db0006e552b84d4ba7aa767a8b931ef8,
title = "Reliability Analyses of Radiographic Measures of Vertebral Body Height Loss in Thoracolumbar Burst Fractures",
abstract = "Objective: In thoracolumbar (TL) burst fractures, vertebral body height loss (VBHL) indicates the degree of instability and constitutes one of the decision criteria for surgical treatment. However, the relative reliability and variability of different measurement techniques for VBHL are unknown. We compared the reliability of different methods used to assess VBHL. Methods: A total of 144 patients with TL burst fractures were included, and lateral radiographs were taken twice at an interval of 2 weeks, which were examined by 3 observers. The measurement methods used included the anterior/posterior vertebral body height compression ratio (APCR), anterior height compression percentage (AHCP), and anterior/posterior vertebral body height compression ratio percentage. To compare the accuracy of measurements according to vertebral degeneration, subjects were divided into 2 groups based on the median age of 50 years. Results: In intraobserver comparisons, the APCR method showed a higher inter- and intraclass correlation coefficient (ICC) (>0.714) compared with the other methods. In interobserver comparisons, the ICC of the APCR (>0.793) was excellent. In intraobserver comparisons of the aged >50-years group, only the APCR method showed an excellent ICC (>0.753), whereas the AHCP method showed a fair to good ICC, and the anterior/posterior vertebral body height compression ratio percentage method had the lowest ICC. In interobserver comparisons of the aged >50-years group, the APCR and AHCP methods showed excellent ICCs. In the aged ≤50-years group, all 3 methods showed similar fair to good ICC values. Conclusions: Based on comparative reliability analyses, we recommend the APCR method as the first-line technique and the AHCP as an alternative technique for measuring VBHL in TL burst fractures.",
keywords = "Burst fracture, Compression ratio, Measurement, Reliability, Vertebral body height loss",
author = "Hong, {Jae Young} and Choi, {Sung Woo} and Kim, {Gi Deok} and Kim, {Hyun Kwon} and Shin, {Byung Joon} and Kim, {Eung Ha} and Lee, {Jae Chul} and Park, {Jin Sung} and Jang, {Hae Dong}",
year = "2019",
month = "9",
doi = "10.1016/j.wneu.2019.05.094",
language = "English",
volume = "129",
pages = "e191--e198",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Reliability Analyses of Radiographic Measures of Vertebral Body Height Loss in Thoracolumbar Burst Fractures

AU - Hong, Jae Young

AU - Choi, Sung Woo

AU - Kim, Gi Deok

AU - Kim, Hyun Kwon

AU - Shin, Byung Joon

AU - Kim, Eung Ha

AU - Lee, Jae Chul

AU - Park, Jin Sung

AU - Jang, Hae Dong

PY - 2019/9

Y1 - 2019/9

N2 - Objective: In thoracolumbar (TL) burst fractures, vertebral body height loss (VBHL) indicates the degree of instability and constitutes one of the decision criteria for surgical treatment. However, the relative reliability and variability of different measurement techniques for VBHL are unknown. We compared the reliability of different methods used to assess VBHL. Methods: A total of 144 patients with TL burst fractures were included, and lateral radiographs were taken twice at an interval of 2 weeks, which were examined by 3 observers. The measurement methods used included the anterior/posterior vertebral body height compression ratio (APCR), anterior height compression percentage (AHCP), and anterior/posterior vertebral body height compression ratio percentage. To compare the accuracy of measurements according to vertebral degeneration, subjects were divided into 2 groups based on the median age of 50 years. Results: In intraobserver comparisons, the APCR method showed a higher inter- and intraclass correlation coefficient (ICC) (>0.714) compared with the other methods. In interobserver comparisons, the ICC of the APCR (>0.793) was excellent. In intraobserver comparisons of the aged >50-years group, only the APCR method showed an excellent ICC (>0.753), whereas the AHCP method showed a fair to good ICC, and the anterior/posterior vertebral body height compression ratio percentage method had the lowest ICC. In interobserver comparisons of the aged >50-years group, the APCR and AHCP methods showed excellent ICCs. In the aged ≤50-years group, all 3 methods showed similar fair to good ICC values. Conclusions: Based on comparative reliability analyses, we recommend the APCR method as the first-line technique and the AHCP as an alternative technique for measuring VBHL in TL burst fractures.

AB - Objective: In thoracolumbar (TL) burst fractures, vertebral body height loss (VBHL) indicates the degree of instability and constitutes one of the decision criteria for surgical treatment. However, the relative reliability and variability of different measurement techniques for VBHL are unknown. We compared the reliability of different methods used to assess VBHL. Methods: A total of 144 patients with TL burst fractures were included, and lateral radiographs were taken twice at an interval of 2 weeks, which were examined by 3 observers. The measurement methods used included the anterior/posterior vertebral body height compression ratio (APCR), anterior height compression percentage (AHCP), and anterior/posterior vertebral body height compression ratio percentage. To compare the accuracy of measurements according to vertebral degeneration, subjects were divided into 2 groups based on the median age of 50 years. Results: In intraobserver comparisons, the APCR method showed a higher inter- and intraclass correlation coefficient (ICC) (>0.714) compared with the other methods. In interobserver comparisons, the ICC of the APCR (>0.793) was excellent. In intraobserver comparisons of the aged >50-years group, only the APCR method showed an excellent ICC (>0.753), whereas the AHCP method showed a fair to good ICC, and the anterior/posterior vertebral body height compression ratio percentage method had the lowest ICC. In interobserver comparisons of the aged >50-years group, the APCR and AHCP methods showed excellent ICCs. In the aged ≤50-years group, all 3 methods showed similar fair to good ICC values. Conclusions: Based on comparative reliability analyses, we recommend the APCR method as the first-line technique and the AHCP as an alternative technique for measuring VBHL in TL burst fractures.

KW - Burst fracture

KW - Compression ratio

KW - Measurement

KW - Reliability

KW - Vertebral body height loss

UR - http://www.scopus.com/inward/record.url?scp=85067308629&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067308629&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2019.05.094

DO - 10.1016/j.wneu.2019.05.094

M3 - Article

C2 - 31121370

AN - SCOPUS:85067308629

VL - 129

SP - e191-e198

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -