Thoracoscopic Transdiaphragmatic Approach for Anterior Body Reconstruction of L2 Burst Fracture

This study describes the surgical technique and results of video-assisted thoracic surgery (VATS) in a patient who underwent reconstruction of an unstable L2 body fracture. There are various surgical treatment options for L2 burst fractures. The optimal method remains controversial. We performed L2 body reconstruction using VATS. An 18-year-old female was seen in the emergency room with paraparesis grade 4 and was diagnosed with a burst fracture of L2. A two-stage procedure was planned. First, urgent posterior decompression and stabilization were performed with dorsal laminectomy and insertion of screw systems at L1 and L3 pedicles. Then, the L2 body was reconstructed with an expandable cage by VATS. Her weakness was improved immediately after decompressive surgery. This surgical approach is an alternative and minimally invasive method for the treatment of traumatic L2 burst fractures.