We reviewed clinical and radiological results of five patients with lower lumbar burst fractures treated by pedicle screws. All patients achieved successful union of the fracture with good alignment and improved their neurological deficits as well as reducing their low back pain. Posterior decompression with reduction of the prolapsed fracture fragment in the spinal canal was useful for treating patients who underwent surgery within four weeks from the time of injury. It may be possible to preserve the lower disc segment in Dennis type B fractures by using posterolateral fusion of the upper disc segment only. To achieve earlier mobility, and reduce the period of bed-rest required, anterior strut grafting may be needed in patients with a burst fracture whose spinal bodies and upper and lower discs are severely destroyed including those with Dennis type D fractures.
