title: Radiographic measurement of the sagittal plane deformity in patients with osteoporotic spinal fractures evaluation of intrinsic error.
abstract: Cobb method has been shown to be the most reliable technique with a reasonable measurement error to determine the kyphosis in fresh fractures of young patients. However, measurement errors may be higher for elderly patients as it may be difficult to determine the landmarks due to osteopenia and the degenerative changes. The aim of this study is to investigate the intrinsic error for different techniques used in evaluation of local sagittal plane deformity caused by OVCF. Lateral X-rays of OVCF patients were randomly selected. Patient group was composed of 28 females and 7 males and the mean age was 62.7 (55-75) years. The kyphosis angle and the vertebral body height were analyzed to reveal the severity of sagittal plane deformity. Kyphotic deformity was measured by using four different techniques; and the vertebral body heights (VBH) were measured at three different points. The mean intra-observer agreement interval for kyphosis angle measurement techniques ranged from +/-7.1 to +/-9.3 degrees while it ranged from +/-4.5 to +/-6.5 mm for VBH measurement techniques. The mean interobserver agreement interval for kyphosis angle ranged from +/-8.2 to +/-11.1 degrees , while it was between +/-4.5 to +/-6.5 mm for vertebral body height measurement techniques. This study revealed that although the intra and interobserver agreement were similar for all techniques, they are still higher than expected. These high intervals for measurement errors should be taken into account when interpreting the results of correction in local sagittal plane deformities of OVCF patients after surgical procedures such as vertebral augmentation techniques.
authors.affiliation: Department of Orthopaedics and Traumatology, Hacettepe University Faculty of Medicine, 06100, Sihhiye, Ankara, Turkey. alanay@hacettepe.edu.tr
authors.forename: Ahmet
authors.initials: A
authors.lastname: Alanay
authors.forename: Murat
authors.initials: M
authors.lastname: Pekmezci
authors.forename: Oguz
authors.initials: O
authors.lastname: Karaeminogullari
authors.forename: Emre
authors.initials: E
authors.lastname: Acaroglu
authors.forename: Muharrem
authors.initials: M
authors.lastname: Yazici
authors.forename: Akin
authors.initials: A
authors.lastname: Cil
authors.forename: Bas
authors.initials: B
authors.lastname: Pijnenburg
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Genç
authors.forename: Fethullah C
authors.initials: FC
authors.lastname: Oner
mesh_terms: D000368:Aged; D004185:Disability Evaluation; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010024:Osteoporosis / Q000150:complications*; D011237:Predictive Value of Tests; D011859:Radiography / Q000379:methods* / Q000592:standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D013131:Spine / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology