Journal of Spine

A Review of Load Sharing Principle for Thoracolumbar Fractures

Abstract

Huilin Yang, Jun Pan and Zhonglai Qian

Summary 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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