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L4 and L5 fractures are different from those at the thoracolumbar area. These differences include anatomy, biomechanics, classification, and treatment possibilities. Given the accessible literature and lack of high-quality information about the management of low lumbar fractures, we describe the case of a young 26-year-old male was referred to our emergency medical center with a severe L4 vertebral body comminuted burst fracture with complete spinal canal compression (AO type 4). Incredible, all neurological functions were intact initially. The patient was cured through a one-stage posterior only vertebrectomy and fusion with preservation of all neurological functions. Clinical and radiologic follow-up was satisfactory after 2 years. In more severe lumbar injuries, decisions contain spinal decompression and stabilization through a posterior or anterior approach based on the surgeon's favorite. In our experience in this patient, a posterior approach only was used both for decompression and stabilization without routine challenging existing in anterior approaches.

asian journal of neurosurgery

One-stage posterior only corpectomy and fusion in the treatment of a unique acute low lumbar L4 burst fracture without neurologic deficit: A case presentation