{"id":"a1b274f0-4116-4fd0-9865-3382bd8fb0e0","slug":"transdural-reduction-of-a-bone-fragment-protruding-into-the-spinal-canal-during-surgical-treatment-of-lumbar-burst-fracture-a-case-report","title":"Transdural reduction of a bone fragment protruding into the spinal canal during surgical treatment of lumbar burst fracture: A case report","authors":["Wakiko Saruta","Toshiyuki Takahashi","Toshihiro Kumabe","Manabu Minami","Ryo Kanematsu","Hiroya Shimauchi Ohtaki","Ryotaro Otsuka","Junya Hanakita"],"abstract":"Background: There have been many reports on the clinical, radiographic, and surgical management of thoracolumbar burst fractures attributed to high-energy trauma. Interestingly, few reports have described how to extract bone fragments associated with these injuries protruding into the spinal canal contributing to significant neurological deficits. Methods: An 18-year-old male presented with a severe L3-level paraparesis (i.e., loss of motor/sensory function below L3 lower extremity hyporeflexia, and sphincter dysfunction: American Spinal Injury Association [ASIA] Impairment Scale B) following a high-speed crash. The computed tomography and magnetic resonance studies revealed a L3 burst fracture with bone fragments protruding into the spinal canal causing marked cauda equina compression. Following a L3-L4 laminectomy, and opening of the dorsal dura, the bone fragments were ventrally impacted into the fractured L3 vertebral body a pedicle/screw L1-L5 fusion was then completed. Results: One month later, the patient recovered to an ASIA Scale of C, (i.e., residual proximal 3/5 and distal 2/5 motor deficits, with partial sensory sparing). Conclusion: Transdural ventral impaction of protruded bone fragments attributed to high speed lumbar burst fractures contributing to significant cauda equina compression can be safely/effectively accomplished.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/a1b274f0-4116-4fd0-9865-3382bd8fb0e0/featured/hero-1781562112819.png","publishDate":"2021-08-16T00:00:00.000Z","doi":"10.25259/SNI_611_2021","categories":["Spine","Technical Note"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/a1b274f0-4116-4fd0-9865-3382bd8fb0e0/pdf"}