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KMID : 1040920210060010061
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Journal of Minimally Invasive Spine Surgery and Technique
2021 Volume.6 No. 1 p.61 ~ p.65
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Minimally Invasive Temporary Posterior stabilization in Isolated Unstable L5 Burst Fracture with Predominant Radiculopathy: A Case Report
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Achalare Ajinkya
Dhawale Arjun
Chaudhary Kshitij Subhash
Choudhury Himanshu
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Abstract
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To report an isolated L5 burst fracture with predominant radiculopathy treated with MIS, implant removal at one year and its clinical and radiological outcomes at two-year follow-up. A 29-year male sustained an isolated burst fracture of the fifth lumbar vertebra after a train accident. After being treated conservatively at a primary centre for 2 weeks, he presented with back pain with severe radicular pain and hypoesthesia over his left leg. CT and MRI showed a retropulsed fragment with ‘reverse cortical sign’ causing severe stenosis. As the symptoms were refractory, he was treated with MIS L4-S1 posterior instrumentation without direct decompression, with post-operative resolution of symptoms. The fracture healed and implant removal was done at one year. Clinical and radiological outcomes were evaluated at 2-year follow-up. Results: At 2-year follow-up, Oswestry Disability Index score was 4%; there was partial remodeling of the spinal canal from 0.5cm2 to 1.5cm2, lumbosacral motion of 15.4°, lumbar lordosis of 30.7°, and with 8.7° loss of segmental L4-S1 lordosis as compared to the immediate postoperative period. In this case of an isolated L5 burst fracture with radiculopathy treated with MIS, there was clinical improvement and motion preservation, with partial remodeling although there was some residual loss of lordosis.
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KEYWORD
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L5 burst fracture, Minimally invasive surgery (MIS), Implant removal, Canal remodeling
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