Implant in situ assembly for all-posterior lumbar vertebral column resection. Technical note

Background: All-posterior lumbar VCR may be less invasive compared to combined retroperitoneal plus dorsal approaches. Stable lumbar vertebral body replacement requires implants with a large footprint to prevent implant subsidence. The narrow corridor between the lumbar nerve roots and the dural tube, however, impedes insertion of such implants via an exclusively posterior approach.To overcome this problem, we performed implant in situ assembly, a new method that enables all-posterior lumbar vertebral column resection (VCR) using large endplates. Methods: Four patients underwent all-posterior lumbar VCR and in situ assembly of the implant. Results: All-posterior lumbar VCR and insertion of an implant with large endplates to support adjacent vertebrae was feasible in all cases. Conclusions: Implant in situ assembly enables all-posterior lumbar VCR using large endplates.