Assessing the impact of radiological measurement methods on forensic medical reports in traumatic vertebral...

Vertebral compression fractures of varying severity and morphology may result from trauma and often require the preparation of a forensic medical report. Given the legal implications, accurate measurement of the compression ratio is critical. This study aims to evaluate whether four literature-defined methods for determining compression ratios are consistent with one another and with radiology reports, and to examine whether the choice of method alters the conclusions of forensic medical reports.

A retrospective review was conducted of forensic reports issued by our Department of Forensic Medicine between June 1, 2014 and June 1, 2024. Forty-two cases met the predefined inclusion criteria. For each vertebral fracture, the compression ratio was calculated using four established methods. Consistency was assessed both among these methods and between each method and the compression ratio documented in the corresponding radiology report. Finally, it was evaluated whether measurement discrepancies would alter the forensic conclusions regarding (1) the effect of the fracture on life functions, (2) permanent weakness or loss of function of one of the senses or organs, and (3) degree of disability.

Agreement among the four measurement methods was weak to moderate, with inconsistency rates of 14.8% to 66.7% compared to radiology reports. Forensic report conclusions varied according to the measurement method.

Method selection significantly influences both calculated compression ratios and the resulting conclusions of forensic reports in vertebral compression fractures. A standardized, universally accepted measurement protocol is therefore required in forensic practice to support fair and consistent legal decisions.