Introduction: This study aims to describe the feasibility and outcomes of the pediculectomy and vertebral trough-cut technique to reduce bony fragments in thoracolumbar burst fractures. This allposterior retrovertebral fragment reduction technique requires the complete removal of the pedicle, followed by cutting a trough ventral to displaced retrovertebral burst fragments to create space for easy posterior to anterior fragment reduction.

Methods: This was a retrospective study of patients with thoracolumbar burst fractures and canal compromise of more than 50% on axial computed tomography (CT). All patients had neurological deficits secondary to spinal fracture. Each patient underwent removal of the pedicle by cutting a trough ventral to the displaced retrovertebral burst fragment to create space for posterior to anterior fracture fragment reduction followed by posterior instrumentation and fusion.

Results: Thirteen patientswith a mean age of 33 (24-50) years were analysed. All patients’ retropulsed fracture fragments were approached via a pediculectomy. Additional trough cut was performed in 9 patients when the retropulsed fragment was deemed to be irreducible. The average post to pre-operative improvement in axial compromise was 60.7% while the average improvement in vertebral height was 33.9% and the average improvement in vertebral body angle was 9 degrees. All patients experienced mean improvement in ASIA grade of 2. Eleven out of thirteen of the patients were able to walk independently at last follow-up.

Conclusion: The pediculectomy and vertebral trough cut technique for the reduction of retropulsed fragments in burst thoracolumbar fractures is feasible and reproducible with good clinical and radiological outcomes.