Epidemiology and inter-observer reliability in identification of sub axial vertebral column fractures type using CT scans

Abstract

Background: Vertebral Column Fractures (VCF) are a major public health concern with a high mortality rate, negative social and economic effects, and substantial morbidity. Through efficient management and preventative measures based on fundamental epidemiological data, the burden of disease can be reduced. Aim and Objectives: The objectives of this research work were to represent the epidemiology of VCF and to assess the interobserver agreement of VCF identification between spine surgeons using AO classification of Computed Tomography (CT) images. Material and Methods: A total of 456 cases of C3 to L5 spinal fractures with CT were noted. Comprehensive epidemiological profile of all the patients with VCF was recorded separately and was analyzed by SPSS software. Two spine surgeons classified 375 CT scans with a single level vertebral fracture using AO classification of the spine. Kappa coefficient (k), was used to find interobserver agreement in assessing of VCF. Results: Totally 456 cases of VCF with CT scan were collected. Mean ±SD age of men was 39.93 ± 12.07 years and women was 41.85 ± 12.22 years. The number of fractures in the 41-50 years age group was dominant (27.85%, n=127). About 82.20% of the patients had sustained a single fracture. The most common level was the thoracolumbar region (T12- L1), accounting for 41.60%. Type A fractures (68.00%) were the leading type of VCF. In deciding the subtype according to AO among single fracture, current study presented a very good interobserver agreement with (k = 0.884 with p-value = 0.018). Conclusion: In summary, current study presented a very good interobserver agreement in identifying the subtypes of VCF according to AO classification and also demonstrated epidemiology of VCF in west coast of south India.

Keywords

• ao classification
• thoracolumbar
• vertebral column fractures