Background:

We retrospectively reviewed the surgical results of posterolateral transpedicular partial corpectomy, cage interbody fusion without anterior vertebral reconstruction in 91 consecutive patients with burst fractures due to spinal cord compression at the thoracic and lumbar spine.

Material and methods:

From February 2009 to October 2015, the review included ninety-one patients (42 females, 49 males), operated on for the diagnoses of thoracic and lumbar burst fractures due to spinal cord compression who underwent unilateral transpedicular posterior partial vertebrectomy (UTPPV) with vertebral reconstruction. Canal decompression was provided by laminectomies, intracanalicular fragments were totally excised and vertebrectomy was provided via transpedicularly, additional adequate exploration provided by root sacrification in thoracal region and root retraction in lumbar region fractures. Neurologic assessment and progression of the patients were noted as Frankel classification preoperative, postoperative 6th and 12th month, and fracture type was noted as an AO classification.

Results:

The mean age was 35.08 ± 9.33 years. Mean follow-up time was 15.42 ± 4.13 months, and there was significant correlation between canal encroachment and preoperative Frankel grade (p<0.0001). The mean kyphotic correction between preoperative and postoperative Cobb angle on anteroposterior radiographs were 27.33 degrees ± 3.51 to 4.38 ± 0.79, and restoration of vertebral height diameter was 42.68 ± 9.08 % to 84.32 ± 6.71 % postoperatively (p<0.05). Mean canal encroachment was 62.32 % ± 14.88. There were no intraoperative mortality or implant failures. There were no additional complications and neurologic sequel during these operations.

Conclusion:

Unilateral pediculotomy performed through a posterior approach provides a reasonable exposure. Bony fragments can be accessed without the need for an anterior approach or the application of posterior instrumentation. The posterior approach has its advantages in emergency surgical conditions, and provides improved surgical exposure, compared to anterior or anterior/posterior approaches, and has a diminished rate of serious complications.

Keywords: Unipedicular corpectomy, burst fracture, Frankel Grade, AO spine