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International Orthopaedics
Published in: International Orthopaedics 12/2017

01-12-2017 | Original Paper

Posterior only approach for fifth lumbar corpectomy: indications and technical notes

Authors: Belal Elnady, Ahmad Shawky, Hamdan Abdelrahman, Essam Elmorshidy, Mohamed El-Meshtawy, Galal Zaki Said

Published in: International Orthopaedics | Issue 12/2017

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Abstract

Purpose

To evaluate the efficacy and safety of a posterior-only approach for L5 corpectomy, with lumbopelvic fixation for treatment of secondaries, infections, or burst fractures.

Methods

Between 2010 and 2013, 17 patients with L5 pathology had corpectomy through a posterior-only approach, with reconstruction of the anterior column using titanium cages filled with bone graft. The indication for surgery was presence of secondaries in nine patients, spondylitis and spondylodiscitis in five patients and burst fractures due to high energy trauma in three patients. All patients underwent detailed neurological examination as well as plain radiography, computed tomography, and magnetic resonance imaging studies.

Results

This study included 17 patients (8 males and 9 females) with a mean age of 48.3 years. The mean operative time was 186.1 minutes with mean blood loss of 744 ml. No intra-operative or immediate post-operative complications were encountered. Three patients died during follow-up due to advanced malignancy. The remaining 14 patients were followed-up for a mean of 24.9 months. One patient had cut through of L3 screws two years after surgery requiring metal removal. One patient had asymptomatic broken screw, with no need for further intervention.

Conclusions

L5 corpectomy is a challenging procedure indicated for treatment of various cases of metastasis, infections, or comminuted fractures. The posterior approach is safe, efficient, and allows both rigid posterior stabilization and anterior reconstruction after L5 corpectomy without the need for an anterior approach and its possible related morbidity.
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Metadata
Title
Posterior only approach for fifth lumbar corpectomy: indications and technical notes
Authors
Belal Elnady
Ahmad Shawky
Hamdan Abdelrahman
Essam Elmorshidy
Mohamed El-Meshtawy
Galal Zaki Said
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 12/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-017-3570-7

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