Year: 2026 | Month: August | Volume: 13 | Issue: 8 | Pages: 121-131
DOI: https://doi.org/10.52403/ijrr.20260813
A Comparative Study of X-Ray and CT-Scan Measurement of Interpedicular Distance in Thoracolumbar Compression Fracture
Al Anshari1, Roni Eka Sahputra2, Muhammad Ade Refdian Menkher2
1Orthopaedic and Traumatology Resident, Dr. M. Djamil Hospital, Andalas University, West Sumatera, Indonesia
2Orthopaedic Spine Surgeon, Department of Orthopaedic and Traumatology, Dr. M. Djamil Hospital, Andalas University, West Sumatera, Indonesia.
Corresponding Author: Al Anshari
ABSTRACT
Interpedicular distance (IPD) is a key radiographic parameter in thoracolumbar compression fracture assessment. While CT scan is the reference standard for spinal morphometry, plain radiography remains the primary imaging modality in resource-limited settings. This study compared IPD measurements from X-ray and CT scan and evaluated their clinical agreement. A retrospective comparative study was conducted on 30 patients with confirmed thoracolumbar compression fractures who underwent both plain radiography and CT scan at Dr. M. Djamil General Hospital, Padang, Indonesia (2023–2024). IPD was measured at three vertebral points (V1, V0, V2) and expressed as a ratio-based IPD index (%). Paired t-test, Pearson correlation, and Bland-Altman analysis were performed. X-ray systematically overestimated absolute IPD compared to CT scan for V1, V0, and V2 (mean overestimation 7.02–8.36%, all p < 0.001), with Bland-Altman limits of agreement spanning up to 0.6 cm. The IPD index (%) showed no significant difference between modalities (p = 0.059), with strong correlations across all variables (r = 0.774–0.910, p < 0.001) and 96.7% of cases within limits of agreement. Plain X-ray should not replace CT scan for absolute IPD measurement in surgical planning. However, the ratio-based IPD (%) demonstrates excellent inter-modality agreement and represents a valid, practical parameter for fracture severity assessment where CT availability is limited.
Keywords: interpedicular distance; thoracolumbar fracture; plain radiography; computed tomography; health services accessibility
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