Single Stage Posterior Lumbar-Sacral Reconstruction with Expendable Cage and Iliac Screw for Fifth Lumbar Fracture-Dislocation

Burst fractures most frequently affect the thoracolumbar spine due to the fulcrum of increased motion occurring at the T12-L1 junction. However, isolated burst fractures of the fifth lumbar (L5) vertebra can occur but are very rare. We present a woman with a fracture-dislocation of the fifth lumbar vertebra complicated by neurological damage. She was treated by posterior surgery with transpedicular instrumentation and an expandable cage via posterior approach. Methods involving a corpectomy, placement of an expandable cage (Synex Cage, Synthes, West Chester, PA, USA), and implantation of posterior instrumentation via a single posterior approach are discussed.