Abstract
IntroductionSurgical treatment for lumbar burst fractures is complex and typically involves either a retroperitoneal corpectomy and/or a posterior pedicle screw fixation. We describe the case of a patient with a lumbar burst fracture who was cured via a less invasive approach that has not been previously reported as standalone treatment.Case presentationThis 25-year-old Caucasian man presented with excruciating axial low back pain exacerbated by any attempt to elevate the head of the bed after a motor vehicle accident. Computed tomography demonstrated a burst L4 fracture without spinal canal compromise. The patient underwent a bilateral vertebroplasty with an injectable polymer that mimics cortical bone. Postoperatively, the patient was progressively mobilized in a thoracolumbar spinal orthosis brace without any recurrence of pain. Postoperative computed tomography showed no loss of height in the L4 vertebral body. At one-year postoperatively, the patient was symptom free and the computed tomography scan showed good fracture healing.ConclusionRetroperitoneal corpectomy and/or posterior multi-segment fixation for lumbar burst fractures without neural compression in young patients are associated with loss of mobility and potential future adjacent level disease. Our limited vertebroplasty intervention with close postoperative clinical monitoring has not been previously described as standalone treatment, and it offers the advantages of less operative morbidity and maintenance of lumbar mobility in selected patients.
Highlights
Surgical treatment for lumbar burst fractures is complex and typically involves either a retroperitoneal corpectomy and/or a posterior pedicle screw fixation
Retroperitoneal corpectomy and/or posterior multi-segment fixation for lumbar burst fractures without neural compression in young patients are associated with loss of mobility and potential future adjacent level disease
Our limited vertebroplasty intervention with close postoperative clinical monitoring has not been previously described as standalone treatment, and it offers the advantages of less operative morbidity and maintenance of lumbar mobility in selected patients
Summary
Current surgical options for lumbar burst fractures without neural compression are associated with loss of mobility and potential future adjacent level disease, which may be unacceptable in young patients. We describe a limited vertebroplasty treatment with close postoperative clinical monitoring that has not been previously described as standalone treatment for this type of fracture, and it offers the advantages of less operative morbidity and maintenance of lumbar mobility in selected patients. Consent Written informed consent was obtained from the patient for publication of this case report and accompanying images. Both authors read and approved the final manuscript. Author details 1Department of Neurosurgery, Louisiana State University, 2020 Gravier Street, Suite 744, New Orleans, LA, USA.
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