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

Chun-Hao Lin, Jeffrey Wu, Ting-Shuo Hsu, Yueh-Ying Hsieh, Chang-Jung Chiang, Chia-Hsien Chen
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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 retro-pulsion 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.
腰椎爆裂性骨折伴椎管和椎间孔狭窄的全内镜副腰椎部分切除术:附技术说明的病例报告
爆裂性骨折在胸腰椎损伤中很常见,通常会导致椎体塌陷,并伴有或不伴有神经功能障碍。虽然传统的开放手术是外科减压的标准方法,但它存在一些缺点和并发症。相反,针对这类患者的全内窥镜脊柱手术仍未得到充分探索。本病例报告介绍了一名 77 岁的患者,他患有 L3 爆裂性骨折,后推力骨碎片造成严重的神经功能缺损,导致椎管受损和右侧 L3-4 椎孔狭窄。该患者接受了全内镜副腰椎入路腰椎部分椎体切除术和椎间孔碎片清除术。此外,还进行了椎体成形术和短节椎弓根螺钉固定术,以恢复矢状排列和脊柱稳定性。术后,患者的疼痛、麻木和肌肉力量明显改善。影像学评估证实,畸形矫正和椎管减压取得了成功。这项研究强调了内窥镜技术在促进爆裂性骨折患者康复方面的优势。然而,研究也承认存在一定的局限性,包括在使用这种方法时需要进一步的研究和专业知识。总之,辅助内窥镜技术有望成为传统开放手术的重要替代方法,在治疗爆裂性骨折的并发症和康复方面具有潜在优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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