Lateral corpectomy and reconstruction for thoracolumbar burst fractures with neurological injury

Abstract

Spine injuries have substantial impact on quality of life, especially when neurologic injury is present, with significant associated healthcare costs. Most spine injuries occur within the thoracolumbar spine, with burst fractures representing a notable proportion. Unstable burst fractures with neurologic deficits come with difficult evaluation and management decisions. Treatment of these injuries has substantially evolved over the last 2 decades. Options for operative management include anterior, posterior, and combined anterior-posterior approaches. Posterior approaches allow for stabilization of fractures, but come with challenges of performing an adequate decompression in the setting of neurologic deficit. Anterior approaches allow for direct decompression, but traditional approaches have noteworthy complications. Growth of minimally invasive spine surgery has helped to mitigate some risks associated with traditional open approaches. Minimally invasive anterior decompression with percutaneous posterior stabilization represents a reasonable management option in unstable thoracolumbar burst fractures with neurologic deficit.