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Lumbar burst fractures are common high-energy spinal injuries often accompanied by neurological deficits. Although endoscopic percutaneous pedicle screw fixation has been applied in thoracolumbar fractures, it cannot be used for lumbar interbody grafting and anterior-middle column reconstruction. This case report introduces the use of arthroscopic-assisted uni-portal spinal surgery combined with transforaminal lumbar interbody fusion for an L3 burst fracture, enabling endoscopic reduction of spinal canal fracture fragments and concurrent interbody fusion. A male patient in his early 30s with severe back pain after a fall was diagnosed with an L3 burst fracture (AO: A3; Denis: IIB; Thoracolumbar Injury Classification and Severity Score: 2; Lumbar Spine Instability Classification: 6). He received percutaneous pedicle screw fixation at L2-L4 and arthroscopic-assisted uni-portal spinal surgery combined with transforaminal lumbar interbody fusion for decompression, fusion, and anterior-middle column stability reconstruction. At the 6-month follow-up, sagittal alignment and intervertebral disc height were well preserved, and solid spinal fusion with Bridwell grade 1 was achieved.
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Zhang et al. (2026) studied this question.
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