PMC6169344_01
Preoperative X-ray of the patient showing Stable burst fracture of L1 vertebra with local kyphosis
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F1
Although her neurological examination was normal, the X-rays and MRI studies confirmed an L1 burst fracture without accompanying neural compression [Figures 1 and 2].
Preoperative magnetic resonance imaging of the patient showing Stable burst fracture of L1 vertebra without disruption of posterior ligaments
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F2
Although her neurological examination was normal, the X-rays and MRI studies confirmed an L1 burst fracture without accompanying neural compression [Figures 1 and 2].
Clinical picture showing bloody serous discharge from the Right lower wound
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F3
Postoperatively, she did well until the third postoperative day at which time she developed severe back pain and serous discharge from the right L2 pedicle wound [Figure 3].
Clinical picture during the wound wash showing serous discharge on tenth postoperative day
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F4
On the tenth postoperative day, she returned to the operating room for a washout; the wound was left open [Figure 4].
Intraoperative photo during debridement showing necrosed muscle tissue
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F5
At this time, all incisions were opened, and the entire bilateral subfascial tracts were explored; the paraspinal muscles were pale, avascular, and non contractile [Figure 5].
Biopsy picture
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F6
Biopsy of the muscle tissue confirmed avascular muscle necrosis [Figure 6].
One-year postoperative X-ray showing consolidation of the fracture with no implant failure or increase in kyphosis
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F7
The patient resumed to her activities after 1 postoperative month, and at 1 year, she returned to normal activities [Figure 7].