Manual Reduction, Subpedicle Approach, and Body Cages to Treat Burst Fracture

Abstract

Manual reduction, subpedicle approach, and body cage to treat burst fracture Thoracolumbar burst fractures occasionally result in severe instability and acute or delayed neurological dysfunction, requiring surgical intervention to decompress spinal cord, reconstruct the vertebral body, correct angular deformity, and restore stability. Even transpedicular decompression and augmentation with the body-cages and short-segment fixation are successful, they are limited in their ability to decompress the contralateral spinal cord and bilateral procedures are necessary. Thus, a posterior far-lateral subpedicle approach to open the lateral vertebral cortex window, creating a tunnel to remove retropulsed bony fragments and pass body cages for full-body augmentation (SpBA) was applied to treat burst fracture. The characteristics of SpBA include unilateral approach, direct decompression, minimal bleeding, short operation time and no posterior instrumentation. In this chapter, according to Li's short-term results [12] indicating that SpBA is effective in preventing adverse effects of adjacent disc injury, the detailed techniques and effects of manual reduction for post-traumatic kyphosis, transpedicle decompression and body augmentation with short-segment fixation were described. The most advanced technique, the unilateral subpedicle approach with body cages and cementation without screw instrumentation, which offers a minimally invasive solution for spinal burst fractures.