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987
The Predictive Value of the Load Sharing Classification Concerning Sagittal Collapse and Posterior Instrumentation
Wessel T Stam1, Jaap Deunk1, Matthijs J Elzinga1
1Amsterdam UMC, Location VU Medical Centre, Amsterdam, Netherlands.
Global Spine Journal
|May 22, 2020
Summary
The Load Sharing Classification (LSC) may not reliably predict sagittal collapse or instrumentation failure in thoracolumbar fractures treated with short-segment posterior instrumentation (SSPI). Current evidence suggests SSPI alone may be sufficient.
Area of Science:
- Spine surgery
- Orthopedic trauma
- Biomechanical analysis
Background:
- The Load Sharing Classification (LSC) was introduced in 1994 to guide surgical treatment for thoracolumbar spine fractures.
- Its utility in predicting implant failure and sagittal collapse remains debated in current literature.
Purpose of the Study:
- To evaluate the predictive accuracy of the LSC for anterior stabilization needs.
- To assess the LSC's value in preventing sagittal collapse and posterior instrumentation failure.
Main Methods:
- Systematic review of electronic databases (PubMed, Medline, Embase, Cochrane Library).
- Inclusion criteria: cohort or clinical trials on thoracolumbar burst fractures assessed by LSC.
Main Results:
- 21 articles were reviewed from 5,082 initially identified.
- 12 studies found no correlation between LSC and outcomes with short-segment posterior instrumentation (SSPI).
- 7 studies found no significant relation; 5 reported no instrumentation failures.
Conclusions:
- SSPI alone may be adequate for thoracolumbar fractures, irrespective of LSC score.
- The LSC's predictive value for sagittal collapse and posterior instrumentation failure appears diminished.
