Three-column reconstruction through the posterior approach alone for the treatment of a severe lumbar burst fracture in Korea: a case report

Abstract

Generally, patients with severe burst fractures, instability, or neurological deficits require surgical treatment. In most cases, circumferential reconstruction is performed. Surgical methods for three-column reconstruction include anterior, lateral, and posterior approaches. In cases involving an anterior or lateral approach, collaboration with general or thoracic surgeons may be necessary because the adjacent anatomical structures are unfamiliar to spinal surgeons. Risks include vascular or lumbar plexus injuries and cage displacement, and in most cases, additional posterior fusion surgery is required. However, the posterior approach is the most common and anatomically familiar approach for surgeons performing spinal surgery. We present a case in which three-column reconstruction was performed using only the posterior approach to treat a patient with a severe lumbar burst fracture.

Keywords: Case reports; Lumbar vertebrae; Spinal fractures; Spinal fusion; Spinal injuries.

Fig. 1.

Abdominopelvic computed tomography performed in the emergency room. (A) Sagittal image. (B) Axial image.

Fig. 2.

Preoperative lumbar magnetic resonance imaging. (A) Sagittal image. (B) Axial image.

Fig. 3.

Intraoperative fluoroscopic images. (A) Anteroposterior image. (B) Lateral image.

Fig. 4.

Postoperative plain radiographs. (A) Immediately postoperative lumbar lateral plain radiograph. (B) Lumbar lateral plain radiograph 1 month after surgery. (C) Lumbar lateral plain radiograph 3 months after surgery. (D) Lumbar anteroposterior plain radiograph 6 months after surgery. (E) Lumbar lateral plain radiograph 6 months after surgery.