L1 Burst Fracture Through an Area of Pseudarthrosis-a Case Report.

Abstract

This is the first report of a traumatic 3-column injury occurring through an asymptomatic pseudarthrosis site. An all-posterior approach can obviate the need for a combined anteroposterior approach to the spine and can avoid all of the complications associated with a separate anterior approach. To our knowledge, there are no reports on the occurrence of a 3-column injury through a pseudarthrosis site and the treatment of this pathology via an all-posterior approach. We present a case of an L1 burst fracture that occurred through an area of pseudarthrosis that resulted in +40° thoracolumbar kyphosis and near complete collapse of the vertebral body with 50% canal compromise. The patient was successfully treated with a posterior vertebral column resection from T11-L3 with anterior column support and a 3-rod construct posteriorly. Postoperatively, alignment was anatomically restored and the patient remained neurologically intact. The all-posterior approach can be useful for the treatment of thoracolumbar traumatic injuries. Asymptomatic pseudarthrosis sites can be an area for traumatic injury that can be successfully treated with an all-posterior approach.