Bisected Vertebral Body Fracture Trapping Cauda Equina: A Case Report

ABSTRACT

In most thoracolumbar burst fractures, the spinal cord or cauda equina is compressed and displaced posteriorly by the retropulsed bone fragments in the spinal canal. We report a rare case of an L3 burst fracture in which the cauda equina was trapped in the crack of a bisected vertebral body with anterior displacement. To decompress the neural elements, we attempted a total laminectomy and facetecomy with manipulation of the retropulsed bone fragment and indirect instrumental reduction, but failed to relieve the cauda equina. Finally, we were able to relieve the cauda equina via a discectomy and bilateral removal of the bony portion that was entrapping the cauda equina. One month after the first surgical procedure, an anterior corpectomy of L3 and interbody fusion with a mesh cage and allograft to support the anterior column were performed.