Predictability of Magerl & McCormack’s Load Sharing Classification on the Metal Failure after Pedicle Screw Fixation in the Thoracolumbar Spine Fracture

Ahn， Myun Whan; Sung Hyuk Park,; Min Chul Sung,; Ahn， Jong Chul; 윤현국

Study Design: A retrograde study of metal failures at thoracolumbar spinal fractures fixed using pedicle screws. Objectives: The predictability and usefulness of the McCormack's classifications for metal failures was compared with Magerl’s classifications. Summary of Literature Review: The load sharing classification was introduced to predict metal failure after short-segmental pedicle screw fixation by McCormack. However, its reliability is uncertain. Materials and Methods: From July 2000 to July 2003, this study examined the plain radiographs and CT images of 31 out of 46 patients who underwent posterior stabilization using pedicle screws for thoracolumbar fractures and could be followed up at least 1 year. Fractures were classified utilizing Denis’s, Magerl’s, and McCormack’s systems. Results: As a result of analysis of relation between metal failure and classification system by Magerl or McCormack, there was no significant difference in its distribution. There was no correlation between the fixation range and metal failures in type C3 fractures, but there was a correlation between short fixation and metal failures in rotational burst fractures in short fixation. Conclusions: In order to prevent metal failures after fixing thoracolumbar spinal fractures by pedicle screws, the stability should be evaluated using Magerl’s classification and McCormack’s total score. In addition, in cases of type C3 fractures according to the Magerl’s classification, reconstructions should be carried out with a long segment fixation or anterior supporting bone grafts, particularly when McCormack’s total score is greater than 7.

Citation status

KCI Citation Counts (0)
REFERENCES (16)
열림/닫힘 버튼
* 2021년 이후 발행 논문의 참고문헌은 현재 구축 중입니다.

[book] Huler RJ / 1977 / Thoracolumbar spine fracture. (in John W. Frmoyer ed. The adult spine-principles and practice / Lippincott-Raven : 1473~

[journal] Mikles MR / 2004 / Posterior instrumentation for thoracolumbar fractures / J Am Acad Orthop Surg 12 : 424~435

[journal] Tezeren G / 2005 / Posterior fixation of thoracolumbar burst fracture: short-segment pedicle fixation versus longsegment instrumentation / J Spinal Disord Tech 18 : 485~488

[journal] Dick W / 1985 / A new device for internal fixation of thoracolumbar and lumbar spine fractures: the ‘fixateur interne’ / Paraplegia 23 : 225~232

[journal] McCormack T / 1994 / The load sharing classification of spine fractures / Spine 19 : 1741~1744

[journal] Guttmann L / 1969 / Spinal deformities in traumatic paraplegics and tetraplegics following surgical procedures / Paraplegia 7 : 38~58

[journal] Denis F / 1984 / Spinal instability as defined by the three column spine concept in acute spinal trauma / Clin Orthop Relat Res 189 : 65~76

[journal] Denis F / 1983 / The three column spine and its significance in the classification of acute thoracolumbar spine injuries / Spine 8 : 817~831

[journal] Magerl F / 1994 / A comprehensive classification of thoracic and lumbar spine injuries / Eur Spine J 3 : 184~201

[journal] McLain RF / 1993 / Early failure of short segment pedicle instrumentation for thoracolumbar fractures / J Bone Joint Surg Am 75 : 162~167

[journal] Carl AL / 1992 / Pedicle screw instrumentation for thoracolumbar burst fractures and fracture-dislocations / Spine 17 : 317~324

[journal] Karlstrom G / 1989 / New principles for treating vertebral injuries. Increased stability gives advantages / Lakartidningen 86 : 2739~2744

[journal] Fancy JP / 1987 / A comparative biomechanical study of spinal fixation using Cotrel-Dubousset instrumentation / Spine 12 : 877~881

[journal] Dekutoski MB / 1993 / Spinal mobility and deformity after Harrington rod stabilization and limited arthrodesis of thoracolumbar fractures / J Bone Joint Surg Am 75 : 168~176

[journal] Daniaux H / 1991 / Application of posterior plating and modifications in thoracolumbar spine injuries. Indication, techniques, and results / Spine 16 : 125~133

[journal] Aligizakis AC / 2003 / Gertzbein and load sharing classifications for unstable thoracolumbar fractures / Clin Orthop Relat Res 411 : 77~85

KJC Korea
Journal Central

Statistics

Tools

Sharing

Issue List

Citation status