====== Lateral pediculectomy ======

Kwon et al., from the Department of Neurosurgery, [[Korea University Guro Hospital]] [[South Korea]] introduced in [[2018]] a [[technique]] and results of retro-pleural/ peritoneal "lateral pediculectomy" for the decompression of [[thoracolumbar fracture]]s and [[reconstruction]] using expandable [[titanium]] [[cage]], and [[circumferential]] [[fixation]] at a single stage.

18 [[patient]]s who had single unstable, burst [[thoracolumbar fracture]] were treated by this technique between January 2014 and December 2016 (T12: 9 cases, L1: 7 cases, L2: 2 cases). They were reviewed retrospectively in terms of radiologic (CT scan and X-ray), clinical [[outcome]]s and [[complication]]s. The results were compared with another cohort of thoracolumbar fractures treated by posterior only surgery.

There was no radiologic complications implying [[pseudoarthrosis]] or [[instrument]] [[failure]] on the postoperative 6 months CT scan. There was also no neurologic deterioration or [[infection]]s during the same period. 2 patients (11.%) of iatrogenic and 1 patient of trauma related injury of the dura were secured without any delayed [[complication]]s. 3 patients (16.7%) of transient [[weakness]] in left hip flexion immediately after operation were observed and recovered within 2 weeks in all cases. 6 patients (33.3%) complained of [[dysesthesia]] and/or [[hypoesthesia]] on incision site.

The present technique suggests "lateral pediclectomy" as a distinct anatomic landmark and surgical tactics to access and remove bony fragment effectively and safely. This provides a more straightforward assess to the burst fragment and helps the surgeon to make better intra-operative decompression strategies. Moreover, this circumferential instrumentation with anterior support and fusion revealed better restoration of the thoracolumbar spine alignment compared to posterior only surgery, with acceptable complications rates
((Kwon WK, Park WB, Lee GY, Kim JH, Park YK, Moon HJ. Decompression with
"[[Lateral pediculectomy]]" and [[circumferential]] reconstruction for unstable
Thoracolumbar Burst Fractures : Surgical Techniques and Results in 18 Patients.
World Neurosurg. 2018 Jul 28. pii: S1878-8750(18)31615-2. doi:
10.1016/j.wneu.2018.07.137. [Epub ahead of print] PubMed PMID: 30064028.
)).