Posterior Reconstruction of Vertebral Body using Expandable Cage for L5 Burst Fracture Dislocation: Case Report

INTRODUCTION A case of young male patients aged 25 years old presented with history of injured from falling heavy object on his back. There was burst Fracture of L5 Vertebrae with grade 3 spondylolisthesis. It was completely different from the types of L5 fracture that had been published up to now. Our patient had combination of a complete burst fracture of the fifth lumbar vertebra with dislocation and complete disruption of the posterior ligamantous and bony complex between L5 and sacrum. We would like to report this unique case of comminuted burst fracture of L5 with grade III spondylolisthesis treated with reconstruction of L5 body from transforaminol approach with the good results & significant neurological improvement till his six month follow up after the operation. CASE REPORT A case of young male patients aged 25 years old presented with history injured from falling heavy object on his back. The physical examination revealed contusion on his back Neurological examination confirmed complete paralysis of L5 and S1 root on both sides. Loss Bladder-bowel function, sphincter tone and peri-anal sensation. Plain radiograph of lumbar-sacral spine showed the anterior dislocation of L5-S1 spondylo-listhesis approximately 75%, with the complete comminuted burst fracture of L5 vertebra. CONCLUSION Anterior support and reconstruction of vertebral body is of immense importance in Lumbar burst fracture, When combined with posterior short segment fixation. This can be achieved with Usage of expandable cages when opted for posterior only approach. They obviate need of anterior approach for reconstruction of vertebral body.