Transforaminal Interbody Impaction of Bone Graft to Treat Collapsed Nonhealed Vertebral Fractures with Endplate Destruction: A Report of Two Cases

الملخص EN

Background.

A collapsed nonhealed vertebral fracture with endplate destruction is a challenging injury to address, as there is no single definitive treatment.

We present two cases using an innovative transforaminal grafting technique to treat these patients.

Case Presentation.

Case 1: a 72-year-old woman had nonunion of an L1 compression fracture with destruction of both endplates.

T12/L1 and L1/L2 transforaminal debridement and impaction of bone graft were performed followed by posterior instrumentation.

At three years follow-up, the fusion mass between T12/L1 and L1/L2 was solid and the patient had minimal pain.

Case 2: a 62-year-old woman had nonunion of an L1 burst fracture with destruction of the lower endplate.

Hemilaminectomy and transforaminal interbody impaction of bone graft was performed.

At three years follow-up, the patient had no back pain and a solid fusion.

In both cases, local kyphosis was corrected and fusion obtained.

Conclusions.

Collapsed nonhealed vertebral body fractures combined with endplate destruction can be successfully treated with a one-step posterior surgery consisting of transforaminal debridement and impaction of bone graft in combination with posterior pedicle instrumentation.