Unilateral biportal endoscopic treatment of complications in a patient with lumbar burst fracture with pedicle screw repositioning and fixation: A case report

Background: Lumbar burst fracture is a common spinal disorder. Currently, the treatment of lumbar burst fracture is mainly internal fixation with pedicle screws. However, complications such as incomplete decompression, displacement of the fracture block secondary to neurological symptoms may occur during the recovery process of its treatment, so there is a certain rate of reoperation. Traditional open reoperation is highly invasive and has a high risk of infection. The unilateral biportal endoscopy (UBE) has the advantages of large operating space and unrestricted use of instruments, and this technology is favored by spine surgeons worldwide. Methods: A 28-year-old male patient with a burst fracture of the L4 vertebral body caused by a high fall injury underwent pedicle screw internal fixation and presented with cauda equina syndrome after surgery. We used UBE to remove part of the lamina and ligamentum flavum at the L3/4 level, repositioned the fracture block. The efficacy of the treatment was assessed by radiologic examination, clinical outcome and lumbar JOA score scale. Results: Post-operative re-examination of CT showed that the fracture block was well reset and the spinal canal were decompressed adequately; the symptoms of cauda equina syndrome were improved and urination function was restored the day after operation; the post-operative lumbar JOA score was 16, with an improvement rate of 35%. Conclusion: UBE revision of postoperative spinal stenosis after lumbar burst fracture is feasible and has the advantages of minimal trauma, wide range of decompression, and high safety, making it a good option for this type of revision surgery. Unilateral biportal endoscopic treatment of complications in a patient with lumbar burst fracture with pedicle screw repositioning and fixation: a case report.