Anterior treatment of thoracolumbar burst fractures

A 46-year-old male was riding an all-terrain vehicle at about 30 mph when he lost control and fell backward off the vehicle, landing on his buttocks and back. He immediately experienced severe back pain and was brought to the nearest hospital for evaluation, and then transferred to a tertiary referral center for treatment of an L1 burst fracture. On evaluation, he complained of severe low back pain, along with numbness and tingling in his lower extremities, but no weakness, or loss of bowel or bladder control. He was tender to palpation over the thoracolumbar junction with no palpable stepoff or interspinous widening. His motor exam was normal, and he had decreased sensation in the L4, L5, and S1 dermatomes. He had no other associated injuries.