The patient after suffering RTA 4 days ago got back pain without loss of consciousness and was admitted elsewhere.

MRI dorsal spine performed showing burst fracture D9 and wedging of D10. CT-scan also confirmed the diagnosis. The patient was transferred to Shmaisani hospital 2 days ago.

On examination: the patient is in complete bed rest and he was neurologically free.

Skeletonization of D8 down to D11 was performed. The lamina of D9 was shifted posteriorly and deformed and the compressing elements from behind were removed trying the keep the acceptable anatomical structures. Using transpedicualr screws 2 at D8 and 2 at D11 and one at the right side of D10, which seems to be intact, distraction reduction was performed trying to gain reduction due to minimal traction and mild angulations of the rods. All the time the procedure was performed using image-intensifier. The body of D9 got acceptable alignment due to liagamentotaxis. A 23 mm bridge was aided to the construct and bicalphos granules 20 cc seeded around the construct and at the fractures sites.

Routine closure of the wound and smooth postoperative recovery and the patient sent to the ward.

The fracture of D9 was unstable one, which could lead to catastrophic residual if neglected.

The body of D10 was partially acceptable and it was used in the fusion process at the healthy pedicle to have more stable construct.