Prone Lateral Corpectomy with Short-Segment Posterior Spinal Fusion for Lumbar Burst Fracture: Report of Two Cases and Technical Outline.

The lateral transpoas approach has become increasingly utilized in the treatment of thoracolumbar spine pathologies. Recent studies report a modified single-position prone lateral transpsoas surgery which incorporates lumbar interbody fusion and pedicle screw fixation. However, few studies demonstrate its utility in corpectomy cases. This report aims to highlight the technique, efficacy, and implications associated with single-position prone lateral transpsoas corpectomy with short-segment posterior spinal fusion in two traumatic cases with unstable burst fractures. Patient demographics, as well as clinical and radiographic outcomes, were reviewed retrospectively. The first patient was a 29-year-old male who presented with severe back and right lower extremity pain after falling from a roof. Imaging revealed an L4 burst fracture with canal compromise and a ventral epidural hematoma. He underwent a single-stage prone lateral L4 corpectomy with open short-segment L3-5 decompression and fusion with complete resolution of symptoms, durable at 6 months follow-up. The second patient, a 60-year-old male, presented with severe back pain and right lower extremity proximal weakness with radiating leg pain after a motor vehicle accident. Imaging revealed an L3 burst fracture with canal compromise. The patient underwent a single-stage prone lateral L3 corpectomy with open short-segment L3-5 decompression and fusion with immediate improvement in pain and weakness. At 4 months follow-up, he continued to endorse resolution of pain with improving strength in his quadriceps. Initial reports regarding this novel approach for traumatic burst fractures demonstrate promising results in terms of safety and efficacy when compared with traditional techniques. Nevertheless, further studies using expanded cohorts with various underlying pathologies are warranted.