What question did this study set out to answer?

To demonstrate the feasibility of single-position robot-assisted lateral lumbar corpectomy for achieving indirect decompression in burst fractures.

July 23, 2026Journal of Neurosurgery Case Lessons0 citations

Single-position robot-assisted lateral lumbar corpectomy with minimally invasive posterior spinal fusion for traumatic burst fracture showing MRI-demonstrated indirect decompression: illustrative case

RBRyan S. BeyerUniversity of California, Irvine Medical Center GFGenevieve FraipontUniversity of California, Irvine ZPZach PenningtonMayo Clinic

Key Points

To demonstrate the feasibility of single-position robot-assisted lateral lumbar corpectomy for achieving indirect decompression in burst fractures.
Performed single-position robot-assisted lateral L4 corpectomy and spinal fusion in a 72-year-old male with an L4 burst fracture.
Utilized MRI to assess postoperative outcomes, focusing on ligamentous changes and spinal canal area.
Implemented ligamentotaxis to restore spinal anatomy without direct decompression.
Postoperative MRI revealed significant indirect decompression with reduced ligamentous buckling and increased spinal canal area.
No resection of ventral retropulsed fragments was needed, demonstrating an effective approach to management.
The method minimized the morbidity commonly associated with open posterior approaches.

Abstract

BACKGROUND: Ligamentotaxis-based indirect decompression using lateral approaches is well described for degenerative lumbar disease, yet its application in managing burst fractures remains underexplored. OBSERVATIONS: A 72-year-old osteopenic male with an L4 burst fracture underwent a single-position robot-assisted lateral L4 corpectomy, L2-3 oblique lumbar interbody fusion, L5-S1 lateral anterior lumbar interbody fusion, and robot-assisted percutaneous segmental fixation from L2 to the ilium. Postoperative MRI demonstrated significant indirect decompression with a decrease in ligamentous buckling and restoration of the spinal canal cross-sectional area. The ligamentotaxis created by the height and lordosis restoration produced adequate decompression without resection of the ventral retropulsed fragments or posterior direct decompression. LESSONS: This case illustrates that single-position lateral lumbar corpectomy can achieve indirect decompression while sparing the morbidity of an open posterior approach. To the authors' knowledge, this is the first report with MRI evidence of indirect decompression following single-position lateral lumbar corpectomy. https://thejns.org/doi/10.3171/CASE26118.

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