gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Single stage corpectomy. Expandable cage insertion and pedicle screw fixation by posterior approach.

Meeting Abstract

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  • Reza Akhavan-Sigari - University Medical Center Göttingen, Department of Neurosurgery, Germany
  • Mehdi Abili - Mashhad University of Medical Sciences, Department of Neurosurgery, Iran
  • Veit Rohde - University Medical Center Göttingen, Department of Neurosurgery, Germany

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocP 111

doi: 10.3205/13dgnc528, urn:nbn:de:0183-13dgnc5284

Published: May 21, 2013

© 2013 Akhavan-Sigari et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Burst fractures represent 10% to 20% of all spine injuries at or near the thoracolumbar junction, and can cause neurologic complications and kyphotic deformity. The goal of surgical intervention is to decompress the neural elements, restore vertebral body height, correct angular deformity, and stabilize the columns of the spine. This single-stage posterior approach for acute thoracic and lumbar burst fractures is a novel unusual technique for corpectomy and expandable cage placement, which was firstly described by Sasani et al. 2009 in 14 patients. As the experience still is very limited, we feel encouraged to report our case series.

Method: The study comprised 5 patients (2 women and 3 men) aged between Feb. 2010 and Oct. 2010, who had 1 level spinal burst fracture between T12 and L4 and who underwent single-stage posterior corpectomy, circumferential reconstruction with expandable-cage placement, and trans pedicle screwing. Neurologic status was classified using the American Spinal Injury Association (ASIA) impairment scale and functional outcomes were analyzed using a visual analogue scale (VAS) for pain before and 10 days and 3months, six months and one year after operation.

Results: Hospital stay after operation was 4 days and the Operation time was 4hours. Neurologic outcome in 4 patients was improved. The mean preoperative VAS score was 7,4 and the mean postoperative VAS score was 2.6. There was significant reduction in the severity of back pain (VAS) and lower limb symptoms 3 month, 6 months and 1 year after operation.

Conclusions: The single stage corpectomy and expandable cage insertion via posterior approach as an unusual approach can be used for traumatic thoracic or lumbar burst fractures. This approach offers some advantages over the classic combined anterior-posterior approach, as that it is familiar to the spine surgeon, eliminates risk of damage to vital visceral-vascular structures, and allows for safe surgical re-exploration. The results from this small series suggest that a single-stage posterior approach should be considered in spine injuries as the main goals of surgery in cases of spinal burst fracture are to decompress neural elements and provide spinal stability. Currently, any procedure that meets these 2 aims with minimum complications is strongly preferred over other methods.