Case series of posterior instrumentation for repair of burst lumbar vertebral body fractures with entrapped neural elements

Abstract

Our institution has demonstrated successful use of a posterior instrumentation, spinal canal decompression, release of entrapped nerve roots, and reduction of the retropulsed segment, in patients with traumatic burst fracture of the lumbar vertebrae complicated by entrapped neural elements.

Recovery with posterior decompression and dural suturing in a patient with cauda equina syndrome caused by lamina entrapment in an unstable burst fracture: A case report

“…This situation is especially dangerous because of the involvement of multiple nerve roots governing lower limb and pelvic organ function [ 11 ]. The prognosis of CES depends heavily on the timeliness of the surgical treatment, with earlier interventions typically resulting in better outcomes, especially in traumatic cases [ 4 , 12 , 13 ]. Specific case details and a comprehensive review of existing reports on CES reinforce this.…”

Low Lumbar Fractures: Unique Biomechanics and Treatment Options

“…Because of the propensity for burst vertebra to consolidate, with loss of anterior column height, strongly constrained rigid systems are mandatory. Choosing a pedicle screw system needs sufficient screw dimension, suitable rod size, and stiff rod connection to the screws to counter against bending moments [41][42][43]. The patient's physiognomies to be measured, including insufficient pedicle size and sacral anatomy to normally insertion screws, and also acceptable bone solidity.…”

“…The lack of acceptable anterior stabilizing instruments sometimes means that both anterior and posterior surgery would be essential. Because of the great vessel positions, the anterior approach is technically dependent [41][42][43].…”