The clinical results and function of the intersegmental disc after posterior-only partial corpectomy for lumbar burst fractures

We treated the burst spinal fracture with posterior subtotal corpectomy and reconstruction. In some cases, the endplate and the adjacent disc can be preserved during the operation. The adjacent disc retained its mobility after the removal of the posterior pedicle screws. This study evaluated the clinical results and function of the intersegmental caudal disc after the removal of posterior pedicle screws for lumbar burst fractures. The study analyzed retrospectively 36 patients with acute burst traumatic lumbar fractures who underwent posterior partial subtotal corpectomy and reconstruction with preservation of the inferior endplate of the fractured vertebral body and the adjacent caudal disc, and sequential removal of the posterior pedicle screw 1 year after the second surgery from March 2015 to December 2021. All patients were followed for approximately 1 year after pedicle screw removal. Demographic data, anterior vertebral body height, local kyphosis, motion, caudal disc degeneration, and clinical outcomes were evaluated. After removal of the posterior pedicle screws, the intersegmental disc retained a range of motion of 10.55 ± 5.58°, and the disc degeneration was graded by Pfirrmann criteria from 2.21 ± 1.15 before first surgery to 3.18 ± 1.46 at last follow-up after second surgery. There were 2 cases of superficial wound infection, and 5 cases of postoperative neuralgia recovering after 3 months. Anterior fusion was achieved, although postoperative subsidence of the mesh was observed in 6 cases and screw loosening in 9 cases. Posterior-only partial subtotal corpectomy with preservation of the adjacent caudal disc not only achieved a good clinical effect, but also preserved intersegmental caudal disc function after removal of posterior pedicle screws approximately 1 year later. This technique is a promising alternative for cases in which the endplate obviates injury.