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Case Reports
. 2021 Feb 18:32:100428.
doi: 10.1016/j.tcr.2021.100428. eCollection 2021 Apr.

Mini-open lateral approach for anterior lumbar corpectomy combined with posterior screw-rod system augmentation for correction of kyphosis

Deniz Sirinoglu  1 , Buse Sarigul  1 , Onur Derdiyok  2 , Ozan Baskurt  1 , Mehmet Volkan Aydin  1
Affiliations
Case Reports

Mini-open lateral approach for anterior lumbar corpectomy combined with posterior screw-rod system augmentation for correction of kyphosis

Deniz Sirinoglu et al. Trauma Case Rep. .

Erratum in

Abstract

Introduction: Traumatic burst fractures most commonly occur in thoracolumbar junction. Maintenance of spinal stability and decompression of spinal canal are the main goals of management in these cases. Either anterior, posterior or combined approaches may be selected. For anterior corpectomy, mini-open lateral incision may be used.

Case: 29 years old male patient, in whom posterior segmental instrumentation had been performed previously, readmitted 4 months later with a complaint of low back pain and urinary and gait incontinence. Radiological scans revealed iatrogenic kyphosis and loosening of uppermost transpedicular screws. Patient was managed via revision of posterior instrumentation and L1 corpectomy with cage and rod insertion.

Result: In patients with thoracolumbar burst fracture, loosening of screws and consequent iatrogenic kyphosis may be seen as a late complication. Combined anterior and posterior approach may regenerate spinal stability in these patients. Moreover; mini-open lateral incision with muscle sparing thoracotomy for anterior approach may cause less postoperative complications.

Keywords: Anterior instrumentation; Burst fracture; Corpectomy; Kyphosis; Mini-open incision; Posterior instrumentation.

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Figures

Fig. 1
Fig. 1
Thoracolumbar CT scan at early postoperative period of posterior stabilization. 1A. Sagittal view shows the decompression of spinal cord at L1 segment. 1B and 1C. Axial view of T11 and T12 levels with screws, respectively.
Fig. 2
Fig. 2
Thoracolumbar CT scan of the patient 5 months after the initial surgery. 2A. Sagittal view showing kyphosis in thoracolumbar junction. 2B. Sagittal view with misalignment of screws in left T11 and T12 vertebrae. 2C and 2D. Axial views of T11 and T12 vertebra with pulled out screws in left side, respectively.
Fig. 3
Fig. 3
Photographs of the anterior corpectomy and instrumentation peroperatively. 3A. Mini- open linear skin incision measured of 9 cm on 10th intercostal space. 3B. L1 corpectomy (arrow indicates the corpectomy level) is performed with high speed drill and Kerrison rongeurs. 3C. After insertion of dynamic expandable cage with autogreft implantation. 3D. After insertion of plaques on T12 and L2 vertebra and dual rod system.
Fig. 4
Fig. 4
Peroperative view of posterior segmental stabilization with screw rod system and two connectors.
Fig. 5
Fig. 5
Postoperative CT scan of both anterior and posterior instrumentation. 5A. Sagittal view of posterior instrumentation via 12 screws, 2 rods and 2 connectors between T9-L3 segments. 5B. Sagittal view with dynamic expandable cage filled with autogreft after corpectomy of L1 vertebra. 5C. Sagittal view of anterior dual-rod system inserted within plaques on T12 and L2 vertebral bodies. 5D. Axial view of anterior dynamic expandable cage and dual-rod system. 5E. Coronal view of anterior dynamic expandable cage and dual rod system.
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References

    1. Huang Z., Hu C., Tong Y., Fan Z., Liu K., Yang B., Zhao C. Percutaneous pedicle screw fixation combined with transforaminal endoscopic spinal canal decompression for the treatment of thoracolumbar burst fracture with severe neurologic deficit: a case report. Medicine (Baltimore) 2020 May 22;99(21):e20276. doi: 10.1097/MD.0000000000020276. PMID: 32481306; PMCID: PMC7249900. - DOI - PMC - PubMed
    1. Tuna M., Bagdatoglu H., Boyar B. Anterior or posterior instrumentation in the treatment of unstable thoracolumbar fractures: a retrospective analysis of 30 cases. Turkish Neurosurgery. 1999;9:8–15.
    1. Li S., Li Z., Hua W., Wang K., Li S., Zhang Y., Ye Z., Shao Z., Wu X., Yang C. Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation: case report and literature review. Medicine (Baltimore) 2017 Dec;96(49):e8770. doi: 10.1097/MD.0000000000008770. PMID: 29245233; PMCID: PMC5728848. - DOI - PMC - PubMed
    1. Shi J., Mei X., Liu J. The influence of correction loss in thoracolumbar fractures treated by posterior instrumentation: a minimum 7-year follow-up. J. Clin. Neurosci. 2011;18:500–503. - PubMed
    1. Wood K.B., Bohn D., Mehbod A. Anterior versus posterior treatment of stable thoracolumbar burst fractures without neurologic deficit. Journal of Spinal Disorders&Techniques. 2005 Feb;18:15–23. - PubMed

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