• Said Sadiqi, Jorrit-Jan Verlaan, A Mechteld Lehr, Jens R Chapman, Marcel F Dvorak, Frank Kandziora, S Rajasekaran, Klaus J Schnake, Alexander R Vaccaro, and F Cumhur Oner.
• Department of Orthopaedics, University Medical Center Utrecht, HP G05.228, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands. s.sadiqi-3@umcutrecht.nl.
• Eur Spine J. 2017 May 1; 26 (5): 1483-1491.

PurposeTo 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).MethodsAn 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.ResultsOf 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.ConclusionsThis 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.

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