Transpedicular corpectomy with posterior expandable cage placement for L1 burst fracture

J Clin Neurosci. 2009 Aug;16(8):1069-72. doi: 10.1016/j.jocn.2008.12.009. Epub 2009 May 20.

Abstract

The surgical management of lumbar burst usually involves either a posterior or an anterior approach. Posterior-only procedures usually rely on ligamentotaxis or manual tamping of bone fragments for decompression of the spinal canal. Transpedicular corpectomies allow for circumferential surgery through a single posterior approach; however, they are rarely done for lumbar burst fractures. The presence of intervening nerve roots is one impediment to the placement of expandable cages to reconstruct the anterior column through the transpedicular approach. Using an adaptation of a technique previously described for the treatment of spinal tumors, we were able to successfully treat a traumatic lumbar burst fracture with an expandable cage from a purely posterior approach. This treatment included decompression of the neural elements, correction of the kyphosis, restoration of vertebral body height and reconstruction of the anterior column using an expandable cage with nerve root preservation. We describe our surgical procedure in this technical note.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Decompression, Surgical / methods*
  • Female
  • Fracture Fixation, Internal / methods*
  • Humans
  • Lumbar Vertebrae / injuries*
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery*
  • Magnetic Resonance Imaging
  • Plastic Surgery Procedures / methods
  • Spinal Fractures / pathology
  • Spinal Fractures / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome