patient was admitted to Shmaisani hospital
16-August-2011 after falling from 5 meters
height without loss of consciousness and with
severe LBP and weak left lower limb with
numbness left foot.
lumbar spine done 16-August-2011 and
CT-scan with LSS X-rays confirmed the presence
of burst fracture L1 with bony compression.
examination: the patient in bed with agonizing
back pain and weak dorsi and planterflexion left
foot 3/5 with numbness and analgesia at left L5 and S1
territories. There is Foley's catheter.
The patient was put under
observation for major vital signs for 24 hours.
Skeletonization of D12, L1
and 2 down to the transverse processii. The
intraspinous ligament is ruptured at D12-L1
level. Using Depuy Spine Expedium polyaxial
transpedicular screws - 2 screws were inserted
to L2 body right 6x45 mm and left 6x40 mm . 2
screws were inserted to D12 body 5x40 mm.
Distraction-reduction was done from the right.
Good reduction of the body of L1 was achieved.
Overdistraction from the left side resulted in
slippage of the left screw at D12 body. The
screw was removed and another polyaxial 5x45 mm
screw was inserted. The distraction was applied
down to the left L2 transpedicular screw. The
Cross Link was applied and BoneSave 40 gm was
delivered to the body of L1 through
transpedicular route left side. All stages
of surgery were under C-arm control. The
construct was checked with forced traction to
closure of the wound. Smooth postoperative
recovery with improvement of the power of
the left foot..