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J Neurol Surg A Cent Eur Neurosurg 2023; 84(05): 489-497
DOI: 10.1055/s-0042-1743515
Technical Note

Single-Stage Posterior Transpedicular Corpectomy and 360-Degree Reconstruction for Thoracic and Lumbar Burst Fractures: Technical Nuances and Outcomes

Carla Daniela Anania
1   Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
,
Beatrice Claudia Bono 
1   Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
2   Department of Biomedical Sciences, Humanitas University, Milan, Italy
,
Mariapia Tropeano
1   Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
2   Department of Biomedical Sciences, Humanitas University, Milan, Italy
,
Maurizio Fornari
1   Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
,
Franco Servadei
2   Department of Biomedical Sciences, Humanitas University, Milan, Italy
3   Department of Neurosurgery, Clinical Institute Humanitas, Rozzano, Lombardia, Italy
,
Francesco Costa
1   Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
2   Department of Biomedical Sciences, Humanitas University, Milan, Italy
› Author Affiliations Funding None.
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Abstract

Background We evaluate the feasibility of a single-stage posterior corpectomy and circumferential arthrodesis with the aid of spinal navigation for the treatment of traumatic thoracolumbar burst fractures.

Methods This was a single-center, retrospective study. Demographics, clinical, and radiologic data of 19 patients who underwent surgery at our institution for thoracolumbar burst fractures between 2016 and 2019 were collected. All patients enrolled in the present study underwent surgery by means of posterior fixation and transpedicular corpectomy with the aid of an intraoperative image-guided neuronavigation system.

Results Postoperative correction of the vertebral height ratio was achieved in all cases, with an average increase of 23.6% (p = 0.0005). No statistical differences (p = 0.9) were found comparing 1- and 3-month postoperative CT scans, in relation to vertebral height ratio. A statistically significant difference was found between the pre- and postoperative kyphotic angles for the thoracolumbar and lumbar segments (p = 0.0018 and 0.005, respectively), but no difference was found between kyphotic angles at the 3-month follow-up. A unilateral approach was performed on 15 patients (79%), while 4 cases (21%) required a bilateral laminectomy. We did not observe any significant intraoperative complication.

Conclusion Single-stage posterior corpectomy and fixation is a safe and effective approach for thoracic and lumbar burst fractures. It provides excellent 360-degree reconstruction in a single surgical stage with satisfactory results in terms of kyphosis reduction, biomechanical stability, and reduced invasiveness. Spinal navigation represents a fundamental tool to overcome some anatomical limits of the presented technique.

Keywords

burst fractures - thoracolumbar fractures - posterior corpectomy - spinal navigation


Publication History

Received: 09 November 2021

Accepted: 28 December 2021

Article published online:
06 April 2022

© 2022. Thieme. All rights reserved.

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