THE LOAD SHARING CLASSIFICATION OF SPINE FRACTURES
THE LOAD SHARING CLASSIFICATION OF SPINE FRACTURES
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DOI：
10.1097/00007632-199408000-00014
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发表时间：
1994-08-01
期刊：
影响因子：
3
通讯作者：
GAINES, RW
中科院分区：
文献类型：
--
作者：
MCCORMACK, T;KARAIKOVIC, E;GAINES, RW
研究设计.对28例三柱脊柱骨折患者进行了3 - 4年随访，这些患者采用第一代VSP（Steffee）螺钉和钢板短节段内固定术和自体植骨融合术进行手术稳定。随访发现10例患者发生螺钉断裂。回顾性检查术前X线片和计算机断层轴位和矢状位重建图像清楚地表明，螺钉断裂均发生在椎体损伤不成比例的患者中。开发了一个评分系统（载荷分配分类），该系统对以下各项进行分级：1）椎体受损量，2）骨折部位碎片的扩散，3）创伤性后凸矫正量。该评分系统可用于术前：1）使用短节段后路椎弓根螺钉植入物时预测螺钉断裂，2）描述回顾性研究中的任何脊柱损伤，或3）选择脊柱骨折进行前路支柱移植重建，短节段型重建。
Study Design. A 3 to 4 year follow-up was performed on a consecutive series of 28 patients who had three-column spinal fractures surgically stabilized by short-segment instrumentation with first generation VSP (Steffee) screws and plates and autograft fusion. The follow-up revealed 10 patients with broken screws.Background Data. Retrospective examination of preoperative radiographs and computed tomographic axial and sagittal reconstruction images clearly demonstrated that the screw fractures all occurred in patients with a disproportionately greater amount of injury to the vertebral body.Results. A point system (the load sharing classification) was developed that grades: 1) the amount of damaged vertebral body, 2) the spread of the fragments in the fracture site, and 3) the amount of corrected traumatic kyphosis.Conclusions. This point system can be used preoperatively to: 1) predict screw breakage when short segment, posteriorly placed pedicle screw implants are being used, 2) describe any spinal injury for retrospective studies, or 3) select spinal fractures for anterior reconstruction with strut graft, short-segment-type reconstruction.