Single-Stage Posterior Unilateral Transpedicular Corpectomy With Circumferential Reconstructive Stabilization for the Treatment of Severe Thoracic and Lumbar Complete Burst Fractures

Study DesignRetrospective study.ObjectiveThe aim of this study is to evaluate the radiological, neurological and clinical outcomes of single-stage posterior unilateral transpedicular corpectomy (PUTC) technique for severe thoracic and lumbar complete burst fractures.MethodsSixteen patients with thoracic and lumbar burst fractures characterized by the involvement of both endplates and thoracolumbar injury score such as a Load Sharing Classification (LSC) point 7 or greater and the Thoracolumbar AO Spine Injury Score (TL AOSIS) 9 or more treated with PUTC technique were retrospectively reviewed. Preoperative and the final follow-up radiological parameters were measured. Demographic data, neurologic function, clinical outcomes and surgery-related complications were further analyzed.ResultsThe mean age was 40.3 years with the average follow-up of 25.6 months. The mean estimated blood loss and operating time were 685.7 ± 268.6 mL and 312.5 ± 50.4 min. Loss of vertebral body height and segmental kyphosis were 59.9% and 14.6° before surgery, which significantly improved to 18.6% and -6.8° at the final follow-up. Solid fusion was achieved in all patients. ASIA grade improvement was significantly observed in 15 patients with incomplete neurologic deficits. The preoperative pain and function level showed a mean VAS score of 8.7 and ODI of 90.6% that improved to 1.6 and 23.7%. None of patients developed iatrogenic nerve root injury.ConclusionsSingle-stage PUTC technique with circumferential reconstruction can achieve sufficient spinal canal decompression, improvement of neurological deficit, ideal kyphosis correction with ventral column reconstruction and the avoidance of anterior approach in patients with severe thoracic and lumbar complete burst fractures.