Inter- and intraobserver agreement on the Load Sharing Classification of thoracolumbar spine fractures

Elzinga, Matthijs J.; Segers, M.J.M.; Siebenga, Jan; Heilbron, Emile A.; Klerk, Elly S.M. de Lange–de; Bakker, Fred C.

doi:10.1016/j.injury.2011.05.013

Cited by 19 publications

(16 citation statements)

References 32 publications

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“…The patients in our population with an LSC < 7 are possibly due to inter-and intraobserver variability of the LSC. Moderate inter-and intraobserver agreement of LSC scores between 3-6 and 7-9 has been reported [45]. Although results are stratified for injury severity, it is still possible that QOL is influenced by accompanying or even later sustained injuries.…”

Section: Limitationsmentioning

confidence: 99%

Thoracoscopic anterior stabilization for thoracolumbar fractures in patients without spinal cord injury: quality of life and long-term results

et al. 2018

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Purpose To determine the health-related quality of life (QOL), safety and radiologic parameters after thoracoscopic treatment of traumatic thoracolumbar fractures using a distractible cage in patients without spinal cord injury (SCI). Methods Retrospective cohort study of patients treated between 2004 and 2012 in a university level-one trauma center. Patient and treatment characteristics were collected from the hospital information system. All available radiographic material was assessed for fracture characteristics and Cobb angle at consecutive times. Patients completed the SF-36 and EQ-5D QOL questionnaires at follow-up. Results 105 patients were treated with a distractible cage, which was performed thoracoscopically in 86 cases, including 16 patients with SCI. Of 70 eligible patients, 46 were available for follow-up and completed the questionnaires at median 49 months after surgery. QOL was lower on most domains compared to the general population. Compared to patients who underwent solely posterior fixation for less severe fractures, QOL did not differ significantly. The complication rate was low (10%) with one re-operation. Mean loss of correction was 6.8° and bony fusion on CT scan was present in 98% of patients. Maintenance of kyphosis correction was significantly better for two segments anterior fixation compared to one segment. Conclusions Thoracoscopic anterior stabilization leads to a high percentage of bony fusion in highly unstable thoracic and thoracolumbar fractures with limited post-operative loss of correction and no hardware failure. QOL of these patients does not return to normal population values but is comparable to that of patients with less severe fractures treated with solely posterior instrumentation. Graphical abstract These slides can be retrieved under Electronic Supplementary Material. Key pointsThoracoscopy, anterior stabilization, titanium cage, thoracic and lumbar fractures, quality of life, kyphosis 1. Traumatic thoracic and lumbar fractures with an insufficient anterior load bearing capacity can be treated with a titanium cage through a minimally invasive thoracoscopic approach.2. Quality of life was compared to a group of patients that underwent solely posterior fixation for (less severe) traumatic fractures.3. Additionally, safety and radiologic parameters were assessed.

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Section: Limitationsmentioning

confidence: 99%

Thoracoscopic anterior stabilization for thoracolumbar fractures in patients without spinal cord injury: quality of life and long-term results

et al. 2018

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“…Dai and Jin [14] showed high levels of agreement when the Load Sharing Classification was used to assess thoracolumbar burst fractures. Elzinga et al [15] results were lower levels than Dai's, but the inter-and intraobserver reliability of the Load Sharing Classification of Spinal fractures could still be rated as fair.…”

Section: Clinical Application Of Load Sharing Classificationmentioning

confidence: 82%

A Review of Load Sharing Principle for Thoracolumbar Fractures

Pan¹

2013

J Spine

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of background datas: The management for thoracolumbar fractures remains challenging. It is still controversial which surgical option and approach can correct the deformity, induce neurological recovery, allow patients early mobilization and return to work with minimal risk of complication. The load sharing classification was proposed to describe the thoracolumbar fracture and guide the surgical approach and widely used.Objectives: To review the related studies reporting the load sharing classification for the management of thoracolumbar fractures, discusses the generation, biomechanics, clinical application and advancement of load sharing classification.Material and Methods: PubMed was used to search for articles published from January 1992 to January 2013 using keywords (thoracolumbar fracture and load sharing). References were checked to identify additional studies.Results: There were 19 original articles that ultimately constituted the basis for the review. 16 prospective or retrospective studies reporting clinical results using load sharing classification to treat the thoracolumbar fracture were listed. The sample size was relatively small and it was difficult to compare the results among different studies without the same outcome measures or length of follow-up periods. Conclusion:The optimal surgical method to reduce the postoperative complications and maintain the favorable long-term result for thoracolumbar fractures, all of these are still the challenges of the spine surgery. The load-sharing theory and the load-sharing classification have made contribution to solve the above problems and laid the theoretical basis and provided the clinical guideline meanwhile.

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“…It can therefore be a valuable alternative to perform a circumferential fusion in order to reduce the deformity with stable results [ 14 – 16 ], using a balloon kyphoplasty [ 17 , 18 ] or an anterior approach [ 19 ]. In this series, rationale for an anterior approach instead of balloon kyphoplasty was based on the important bone defect on the initial CT-scan or the presence of a disc disruption on the preoperative MRI.…”

Section: Discussionmentioning

confidence: 99%

Minimal Invasive Circumferential Management of Thoracolumbar Spine Fractures

Pesenti

Graillon

Mansouri

et al. 2015

BioMed Research International

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Introduction. While thoracolumbar fractures are common lesions, no strong consensus is available at the moment. Objectives. The aim of this study was to evaluate the results of a minimal invasive strategy using percutaneous instrumentation and anterior approach in the management of thoracolumbar unstable fractures. Methods. 39 patients were included in this retrospective study. Radiologic evaluation was based on vertebral and regional kyphosis, vertebral body height restoration, and fusion rate. Clinical evaluation was based on Visual Analogic Score (VAS). All evaluations were done preoperatively and at 1-year follow-up. Results. Both vertebral and regional kyphoses were significantly improved on postoperative evaluation (13° and 7° versus −1° and −9° P < 0.05, resp.) as well as vertebral body height (0.92 versus 1.16, P < 0.05). At 1-year follow-up, mean loss of correction was 1°. A solid fusion was visible in all the cases, and mean VAS was significantly reduced form 8/10 preoperatively to 1/10 at the last follow-up. Conclusion. Management of thoracolumbar fractures using percutaneous osteosynthesis and minimal invasive anterior approach (telescopic vertebral body prosthesis) is a valuable strategy. Results of this strategy offer satisfactory and stable results in time.

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Inter- and intraobserver agreement on the Load Sharing Classification of thoracolumbar spine fractures

Cited by 19 publications

References 32 publications

Thoracoscopic anterior stabilization for thoracolumbar fractures in patients without spinal cord injury: quality of life and long-term results

Thoracoscopic anterior stabilization for thoracolumbar fractures in patients without spinal cord injury: quality of life and long-term results

A Review of Load Sharing Principle for Thoracolumbar Fractures

Minimal Invasive Circumferential Management of Thoracolumbar Spine Fractures

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