Comparison of computed tomography and plain radiography in assessing traumatic spinal deformity

An imaging study assessing agreement between computed tomographic (CT) scans and plain radiographs when measuring acute thoracolumbar spinal deformity.

To compare the ability of the screening CT scans to measure spinal deformity in the thoracolumbar spine with that of portable plain radiographs.

At the time of arrival at many trauma centers, patients undergo screening whole body CT as the initial imaging evaluation for trauma. The thoracolumbar spine is well visualized on both coronal and sagittal reconstructions.

Images of patients who underwent screening CT and portable supine plain radiography of thoracolumbar fractures were reviewed. Four observers, at 2 separate times, measured pathologic kyphosis and scoliosis on each image by using the Cobb method. Data were analyzed for statistical differences.

In the sagittal plane, screening CT scans and plain radiographs showed an average mean difference of -1.13 degrees+/-SD of 3.76 degrees. In the coronal plane, CT scans and radiographs showed an average mean difference of 0.10 degrees+/-SD of 2.52 degrees. The interobserver correlation coefficients among the 4 observers were 0.913 in the sagittal plane and 0.953 in the lateral plane, indicating excellent interobserver correlation.

Screening CT demonstrates excellent correlation with plain radiography for measuring thoracolumbar spinal deformity in the coronal and sagittal planes for patients with trauma.