Surgical treatment and clinical follow-up of lumbar burst fracture with cauda equina dural hernia
LI Song
SHI Ming
YANG Yinan
YANG Chengwang
LUO Man
LI Xiaofeng
Abstract：Objective To explore the surgical treatment of lumbar burst fractures with cauda equina herniation,and to evaluate its therapeutic effect and safety through clinical follow-up.Methods A retrospective analysis was performed on 24 patients with lumbar burst fractures complicated by cauda equina herniation,who were admitted to two hospitals from March 2019 to September 2022.All patients underwent posterior lumbar decompression,screw-rod system internal fixation,and lamina reconstruction surgery.The patients were followed up for more than 12 months postoperatively,undergoing assessments of American Spinal Injury Association(ASIA)motor nerve function classification,lumbar lordosis angle,spinal canal invasion rate,anterior vertebral compression rate,and fracture healing status.Measurements,records,and statistical analyses were performed.Results After follow-up,the tear of the dural sac was repaired in all patients,and the injury of the cauda equina nerve fibers recovered to different degrees.The postoperative ASIA motor nerve function grade was improved and the fracture was restored well.The average fracture healing time was 6.2 months.The injured vertebral body showed no significant collapse,the internal fixation was good,and there was no loosening or breakage of pedicle screws.Conclusion The treatment of lumbar burst fractures with cauda equina herniation by posterior lumbar decompression,screw-rod fixation,and lamina reconstruction is effective.In this surgery,the ruptured lamina is removed,long-segment screw-rod reduction and fixation are used to repair the torn dural sac and injured cauda equina nerve.At the same time,artificial lamina is used for lamina reconstruction.This surgery uses a single approach to solve the problems of decompression,reduction,fixation,reconstruction,cauda equina and dural sac repair,with accurate surgical effects,fewer complications,and high safety.It is a better treatment choice.
Keywords：burst fracture of lumbar vertebrarupture of dura matercauda equina hernia
Publication Date：2023-12-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 11-16 )