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Measurement techniques for lower cervical spine injuries: consensus statement of the Spine Trauma Study Group.

Bono CM, Vaccaro AR, Fehlings M, Fisher C, Dvorak M, Ludwig S, Harrop J

Department of Orthopaedic Surgery, Boston Medical Center, Boston, MA 02118-2393, USA. bonocm@prodigy.net

STUDY DESIGN: Literature review. OBJECTIVES: It was the purpose of the Spine Trauma Study Group to compile a collection of clinically useful imaging methods used in lower cervical spine trauma and to describe in detail how these measurements should be made. SUMMARY OF BACKGROUND DATA: Injury detection, description, and treatment decision-making rely on accurate imaging of the lower cervical spine. However, a standard set of imaging measurement techniques for this region does not exist. While most clinicians have developed their own methods of describing radiographic pathology, this variability often leads to confusion in developing an agreed on classification system and limits treatment recommendations. METHODS: The available literature concerning measurement of injury characteristics after lower cervical trauma was reviewed. Consensus of the most potentially useful measurement methods among the surgeon members of the Spine Trauma Study Group was achieved. RESULTS: These measurements included the following: kyphosis (Cobb angle and posterior vertebral body tangent methods); vertebral body translation; vertebral body height loss; maximal spinal canal compromise and spinal cord compression; facet fracture fragment size; and percentage facet subluxation. CONCLUSIONS: A consistent and standard measurement technique among clinicians with regards to imaging of lower cervical spine trauma should positively influence treatment outcome. However, it is through prospective study that the clinical significance of these recommendations will be scientifically established.

Published 1 March 2006 in Spine, 31(5): 603-9.
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