Unilateral Biportal Endoscopic-Guided Transcorporeal Vertebroplasty with Neural Decompression for Treating a Traumatic Lumbar Fracture of L5.

Abstract

Lumbar burst fractures (complete or incomplete) of L5 have a low incidence, accounting for 1.2% of all spinal burst fractures. Treatment for these fractures remains controversial. Decompression of neural elements and stabilization of the spine to preserve lordosis and avoid kyphotic deformity are recommended when a patient has a neurological deficit and an unstable fracture. Otherwise, the fracture could be managed conservatively. We report a detailed step-by-step unilateral biportal endoscopy technique used in a patient with an L5 incomplete burst fracture and neurological deficit. The patient had an acceptable immediate postoperative course; lower back pain and radicular symptoms improved significantly after surgery. Our unilateral biportal endoscopy technique for L5 incomplete burst fractures offers the capability to perform enough decompression of neural elements and assist other procedure-related maneuvers under direct endoscopic visualization. This technique could be considered another minimally invasive spine surgery option for treating selected patients with L5 incomplete burst fractures.