J Minim Invasive Spine Surg Tech.  2024 Jan;9(Suppl 1):S34-S40. 10.21182/jmisst.2023.00906.

Full Endoscopic Paramedian Partial Lumbar Corpectomy for a Lumbar Burst Fracture With Spinal Canal and Foraminal Stenosis: A Case Report With a Technical Note

• Lin CH
• Wu J
• Hsu TS
• Hsieh YY
• Chiang CJ
• Chen CH

• KMID: 2562245
• DOI: http://doi.org/10.21182/jmisst.2023.00906

Abstract

Burst fractures are common in thoracolumbar spinal injuries, often resulting in vertebral collapse with or without neurological deficits. While traditional open surgery is the standard approach for surgical decompression, it has some drawbacks and complications. Conversely, full endoscopic spine surgery remains underexplored for these patients. This case report presents a 77-year-old patient with an L3 burst fracture and severe neurological deficits caused by retropulsion bone fragments, leading to spinal canal compromise and right L3–4 foraminal stenosis. The patient underwent a full endoscopic paramedian approach for partial lumbar corpectomy and foraminal fragment removal. Vertebroplasty and short-segment pedicle screw fixation were also performed to restore sagittal alignment and spinal stability. After surgery, the patient experienced significant improvements in pain, numbness, and muscle strength. Radiographic assessments confirmed successful correction of the deformity and decompression of the spinal canal. The study emphasizes the benefits of endoscopic techniques in enhancing patient recovery for burst fractures. However, certain limitations are acknowledged, including the need for further research and expertise in utilizing this approach. In conclusion, paramedian endoscopy shows promise as a valuable alternative to traditional open surgery, offering potential advantages in terms of complications and recovery for burst fracture management.

Keyword

Lumbar vertebrae; Burst fracture; Endoscopy; Corpectomy; Foraminal stenosis