title: Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study.
abstract: To investigate whether wide variations are seen in the measurement techniques preferred by spine surgeons around the world to assess traumatic fracture kyphosis and vertebral body height loss (VBHL).
  
  
  
  An online survey was conducted at two time points among an international community of spine trauma experts from all world regions. The first survey (TL-survey) focused on the thoracic, thoracolumbar and lumbar spine, the second survey (C-survey) on the subaxial cervical spine. Participants were asked to indicate which measurement technique(s) they used for measuring kyphosis and VBHL. Descriptive statistics, frequency analysis and the Fisher exact test were used to analyze the responses.
  
  
  
  Of the 279 invited experts, 107 (38.4 %) participated in the TL-survey, and 108 (38.7 %) in the C-survey. The Cobb angle was the most frequently used for all spine regions to assess kyphosis (55.6-75.7 %), followed by the wedge angle and adjacent endplates method. Concerning VBHL, the majority of the experts used the vertebral body compression ratio in all spine regions (51.4-54.6 %). The most frequently used combination for kyphosis was the Cobb and wedge angles. Considerable differences were observed between the world regions, while fewer differences were seen between surgeons with different degrees of experience.
  
  
  
  This study identified worldwide variations in measurement techniques preferred by treating spine surgeons to assess fracture kyphosis and VBHL in spine trauma patients. These results establish the importance of standardizing assessment parameters in spine trauma care, and can be taken into account to further investigate these radiographic parameters.
authors: Department of Orthopaedics, University Medical Center Utrecht, HP G05.228, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands. s.sadiqi-3@umcutrecht.nl.
authors: Said
authors: S
authors: Sadiqi
authors: Department of Orthopaedics, University Medical Center Utrecht, HP G05.228, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
authors: Jorrit-Jan
authors: JJ
authors: Verlaan
authors: Department of Orthopaedics, University Medical Center Utrecht, HP G05.228, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
authors: A Mechteld
authors: AM
authors: Lehr
authors: Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, USA.
authors: Jens R
authors: JR
authors: Chapman
authors: Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.
authors: Marcel F
authors: MF
authors: Dvorak
authors: Center for Spinal Surgery, BGU-Hospital, Frankfurt, Germany.
authors: Frank
authors: F
authors: Kandziora
authors: Department of Orthopaedic and Spine Surgery, Ganga Hospital, Coimbatore, India.
authors: S
authors: S
authors: Rajasekaran
authors: Center for Spinal Surgery, Schön Klinik Nürnberg Fürth, Fürth, Germany.
authors: Klaus J
authors: KJ
authors: Schnake
authors: Department of Orthopaedics, Thomas Jefferson University, Philadelphia, PA, USA.
authors: Alexander R
authors: AR
authors: Vaccaro
authors: Department of Orthopaedics, University Medical Center Utrecht, HP G05.228, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
authors: F Cumhur
authors: FC
authors: Oner
mesh_terms: D001837:Body Weights and Measures / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging*; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D016103:Spinal Fractures / Q000000981:diagnostic imaging*; D013131:Spine / Q000000981:diagnostic imaging*; D011795:Surveys and Questionnaires
keywords: International survey; Kyphosis; Radiographic measurement; Spine trauma; Vertebral body height loss